1
|
Janstrup AK, Nørreslet LB, Toft-Hansen JM, Ofenloch R, Agner T, Yüksel YT. Assessment of hand eczema severity by patients using the hand eczema severity index (HECSI). J Eur Acad Dermatol Venereol 2023; 37:2349-2354. [PMID: 37432043 DOI: 10.1111/jdv.19329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Hand eczema severity index (HECSI) is a widely used tool for assessment of hand eczema (HE) severity. Generally, HECSI has been used by health care providers, and a validation of the HECSI tool when used by patients is lacking. OBJECTIVES To evaluate the construct validity and reliability of HECSI as a tool for patients based on comparison to HECSI assessments by physicians. METHODS Patients with HE, enrolled from the dermatological outpatient clinic, Bispebjerg Hospital, assessed HE severity with a patient version of HECSI (patient-HECSI). Afterwards, HECSI was assessed by a trained physician (physician-HECSI). RESULTS This study found a strong correlation and very good absolute agreement between patient-HECSI and physician-HECSI assessments with a correlation coefficient of 0.756 and intraclass correlation coefficient (ICC) of 0.844. Cronbach's alpha was 0.861 indicating very good internal consistency. CONCLUSION With a strong construct validity and reliability, the patient-HECSI may be used by patients as a patient-reported outcome assessing their personal HE severity.
Collapse
Affiliation(s)
- Anne Klose Janstrup
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Line Brok Nørreslet
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | | | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Tove Agner
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | | |
Collapse
|
2
|
Amruthalingam L, Mang N, Gottfrois P, Gonzalez Jimenez A, Maul JT, Kunz M, Pouly M, Navarini AA. Objective hand eczema severity assessment with automated lesion anatomical stratification. Exp Dermatol 2023; 32:521-528. [PMID: 36627238 DOI: 10.1111/exd.14744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 12/23/2022] [Accepted: 01/07/2023] [Indexed: 01/12/2023]
Abstract
Hand eczema (HE) is one of the most frequent dermatoses, known to be both relapsing and remitting. Regular and precise evaluation of the disease severity is key for treatment management. Current scoring systems such as the hand eczema severity index (HECSI) suffer from intra- and inter-observer variance. We propose an automated system based on deep learning models (DLM) to quantify HE lesions' surface and determine their anatomical stratification. In this retrospective study, a team of 11 experienced dermatologists annotated eczema lesions in 312 HE pictures, and a medical student created anatomical maps of 215 hands pictures based on 37 anatomical subregions. Each data set was split into training and test pictures and used to train and evaluate two DLMs, one for anatomical mapping, the other for HE lesions segmentation. On the respective test sets, the anatomy DLM achieved average precision and sensitivity of 83% (95% confidence interval [CI] 80-85) and 85% (CI 82-88), while the HE DLM achieved precision and sensitivity of 75% (CI 64-82) and 69% (CI 55-81). The intraclass correlation of the predicted HE surface with dermatologists' estimated surface was 0.94 (CI 0.90-0.96). The proposed method automatically predicts the anatomical stratification of HE lesions' surface and can serve as support to evaluate hand eczema severity, improving reliability, precision and efficiency over manual assessment. Furthermore, the anatomical DLM is not limited to HE and can be applied to any other skin disease occurring on the hands such as lentigo or psoriasis.
Collapse
Affiliation(s)
- Ludovic Amruthalingam
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Lucerne School of Computer Science and Information Technology, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Nora Mang
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Philippe Gottfrois
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | | | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zürich, Zurich, Switzerland
| | - Michael Kunz
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Marc Pouly
- Lucerne School of Computer Science and Information Technology, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Alexander A Navarini
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| |
Collapse
|
3
|
Yüksel YT, Agner T, Ofenloch R. New evidence on the minimal important change (MIC) for the Hand Eczema Severity Index (HECSI). Contact Dermatitis 2021; 85:164-170. [PMID: 33656746 DOI: 10.1111/cod.13828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND How changes in hand eczema (HE) severity correlate with the single scores on the Hand Eczema Severity Index (HECSI) is sparsely investigated and particularly needed in clinical trials. OBJECTIVES To find the minimal important change (MIC) for HECSI based on patient's and physician's assessments using different methods. METHODS In this prospective follow-up study, three different anchors were used: two anchor questions for patients and physician, respectively, and the Physician Global Assessment (PGA) with a photographic guide. MIC was estimated by mean change in patients with a one-step increase to anchor-questions, receiver-operating characteristic (ROC) plot, and smallest detectable change (SDC). RESULTS One hundred fifty-two patients with HE (63.8% female) were included at baseline (89% completed follow-up). The mean change, ROC cutoff, and SDC values were 7.1, 4.5, 21.4 (patient-rating), 8.2, 4.5, 8.3 (physician-rating), and 16.6, 6.5, 27.1 points (PGA), respectively. SDC stratified by baseline severity was 2.9 and 11 points for mild and moderate-severe HE (physician-rating), respectively. CONCLUSION Identification of the MIC for the HECSI is important in relation to evaluation of treatment, intervention, and sample-size calculations. An improvement of 8.3 points on the HECSI is recommended as the MIC. MIC values may differ according to baseline severity, and this variation should be clarified in future studies.
Collapse
Affiliation(s)
- Yasemin Topal Yüksel
- Department of Dermatology, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tove Agner
- Department of Dermatology, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
4
|
Matricardi PM, Dramburg S, Alvarez‐Perea A, Antolín‐Amérigo D, Apfelbacher C, Atanaskovic‐Markovic M, Berger U, Blaiss MS, Blank S, Boni E, Bonini M, Bousquet J, Brockow K, Buters J, Cardona V, Caubet J, Cavkaytar Ö, Elliott T, Esteban‐Gorgojo I, Fonseca JA, Gardner J, Gevaert P, Ghiordanescu I, Hellings P, Hoffmann‐Sommergruber K, Fusun Kalpaklioglu A, Marmouz F, Meijide Calderón Á, Mösges R, Nakonechna A, Ollert M, Oteros J, Pajno G, Panaitescu C, Perez‐Formigo D, Pfaar O, Pitsios C, Rudenko M, Ryan D, Sánchez‐García S, Shih J, Tripodi S, Van der Poel L, Os‐Medendorp H, Varricchi G, Wittmann J, Worm M, Agache I. The role of mobile health technologies in allergy care: An EAACI position paper. Allergy 2020; 75:259-272. [PMID: 31230373 DOI: 10.1111/all.13953] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 06/12/2019] [Indexed: 12/24/2022]
Abstract
Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the "Be He@lthy, Be Mobile" WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the "General Data Protection Regulation" and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed.
Collapse
Affiliation(s)
- Paolo Maria Matricardi
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité ‐ University Medicine Berlin Berlin Germany
| | - Stephanie Dramburg
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité ‐ University Medicine Berlin Berlin Germany
| | - Alberto Alvarez‐Perea
- Allergy Service Hospital General Universitario Gregorio Marañón Madrid Spain
- Gregorio Marañón Health Research Institute Madrid Spain
| | | | - Christian Apfelbacher
- Medical Sociology, Institute of Epidemiology and Preventive Medicine University of Regensburg Regensburg Germany
| | | | - Uwe Berger
- Department of Oto‐Rhino‐Laryngology Medical University of Vienna Vienna Austria
| | - Michael S. Blaiss
- Medical College of Georgia at Augusta University Augusta Georgia USA
| | - Simon Blank
- Center of Allergy and Environment (ZAUM), School of Medicine and Helmholtz Center Munich Technical University of Munich Munich Germany
| | - Elisa Boni
- Allergy Unit Santo Spirito Hospital Alessandria Italy
| | - Matteo Bonini
- National Heart and Lung Institute Royal Brompton Hospital & Imperial College London London UK
- Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
- Universita’ Cattolica del Sacro Cuore Rome Italy
| | - Jean Bousquet
- University Hospital Montpellier France
- Contre les MAladies Chronique spour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site MACVIA‐France Montpellier France
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, School of Medicine Technical University of Munich Munich Germany
| | - Jeroen Buters
- Center of Allergy and Environment (ZAUM), School of Medicine and Helmholtz Center Munich Technical University of Munich Munich Germany
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine Hospital Vall d'Hebron Barcelona
- ARADyAL Research Network Barcelona Spain
| | - Jean‐Christoph Caubet
- Department of the Child and Adolescent, Pediatric Allergy Unit Geneva University Hospital Geneva Switzerland
| | - Özlem Cavkaytar
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Goztepe Training and Research Hospital Istanbul Medeniyet University Istanbul Turkey
| | - Tania Elliott
- New York University Medical Center New York New York USA
| | | | - Joao A. Fonseca
- CINTESIS, Center for Health Technology and Services Research, Faculty of Medicine University of Porto Porto Portugal
- MEDIDA, Lda Porto Portugal
- MEDCIDS, Dpt. of Community Medicine, Information, and Health Sciences, Faculty of Medicine University of Porto Portugal
| | - James Gardner
- Great North Children's Hospital Newcastle UK
- Newcastle University Newcastle UK
| | - Philippe Gevaert
- Department of Otorhinolaryngology Ghent University Ghent Belgium
| | | | - Peter Hellings
- Euforea Brussels Belgium
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology KU Leuven Leuven Belgium
| | | | - A. Fusun Kalpaklioglu
- Department of Immunology and Allergic Diseases Kirikkale University School of Medicine Kırıkkale Turkey
| | | | | | - Ralph Mösges
- Faculty of Medicine, Institute of Medical Statistics and Computational Biology University of Cologne Cologne Germany
- CRI ‐ Clinical Research International Ltd. Cologne Germany
| | - Alla Nakonechna
- Department of Allergy Broadgreen Hospital Liverpool UK
- Liverpool Hope University Liverpool UK
| | - Markus Ollert
- Department of Infection and Immunity Luxembourg Institute of Health Esch‐sur‐Alzette Luxembourg
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis University of Southern Denmark Odense C Denmark
| | - José Oteros
- Center of Allergy and Environment (ZAUM), School of Medicine and Helmholtz Center Munich Technical University of Munich Munich Germany
| | - Giovanni Pajno
- Allergy Unit‐ Department of Pediatrics University of Messina Messina Italy
| | - Catalina Panaitescu
- Family Medicine Solo Practice RespiRO – Romanian Primary Care Respiratory Group Bucharest Romania
| | - Daniel Perez‐Formigo
- Department of Ophthalmology Hospital Universitario de Torrejon Madrid Spain
- Faculty of Medicine University of Francisco de Vitoria (UFV) Pozuelo de Alarcon, Madrid Spain
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | | | | | - Dermot Ryan
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics University of Edinburgh Edinburgh UK
- Optimum Patient Care Cambridge UK
| | - Silvia Sánchez‐García
- Allergy Unit Hospital Infantil Universitario Niño Jesús Madrid Spain
- Spanish Research Network on Allergy (ARADyAL: Red Nacional de Alergia ‐Asma, Reacciones Adversas y Alérgicas‐) of the Carlos III Health Institute Madrid Spain
| | - Jennifer Shih
- Emory University and Children's Healthcare of Atlanta Atlanta Georgia USA
| | | | | | - Harmieke Os‐Medendorp
- Department of Dermatology and Allergology University Medical Center Utrecht The Netherlands
| | - Gilda Varricchi
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI) University of Naples Federico II Naples Italy
| | - Jörn Wittmann
- Selbstregulierung Informationswirtschaft eV Berlin Germany
| | - Margitta Worm
- Department of Dermatology and Allergology, Allergy‐Center‐Charité Charité ‐ Universitätsmedizin Berlin Berlin Germany
| | | |
Collapse
|
5
|
Oosterhaven JAF, Schuttelaar MLA. Responsiveness and interpretability of the Hand Eczema Severity Index. Br J Dermatol 2019; 182:932-939. [PMID: 31260086 PMCID: PMC7186841 DOI: 10.1111/bjd.18295] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2019] [Indexed: 11/29/2022]
Abstract
Background The Hand Eczema Severity Index (HECSI) is used to measure the severity of hand eczema. It is unclear what HECSI scores mean and what is the minimally important change (MIC). Furthermore, its responsiveness has not been studied. Objectives To study the responsiveness and interpretability of the HECSI. Methods This was a prospective study covering two time points: baseline and after 4–12 weeks. Responsiveness was assessed using a criterion approach, with at least one‐step improvement on the ‘Photographic guide for severity of hand eczema’ as the anchor for important improvement. Interpretability of single scores was determined by defining severity bands based on agreement with the anchor. For change scores, the smallest detectable change (SDC) was calculated in patients indicating no change and the MIC was obtained in patients indicating that they had changed using three methods: mean cutoff, receiver operating characteristic (ROC) curve and 95% limit. Results In total, 294 patients participated (160 male, mean age 44·9 years). HECSI scores improved or deteriorated in parallel with the anchor. The area under the ROC curve was 0·86 (95% confidence interval 0·81–0·91). The final severity band for single scores had a κ‐coefficient of agreement of 0·694: clear, 0; almost clear, 1–16; moderate, 17–37; severe, 38–116; very severe, ≥ 117. The SDC in 93 unchanged patients was 40·3 points. The obtained MIC values were all smaller than the SDC. Conclusions The HECSI has good responsiveness. This study gives meaning to HECSI scores, which can be applied to clinical decision making and the design of clinical trials. We recommend that an improvement of 41 points on the HECSI is regarded as the minimally measurable true change. What's already known about this topic? The Hand Eczema Severity Index (HECSI) is one of the most widely used measurement instruments to measure the severity of hand eczema. The HECSI has good reliability, but its responsiveness and interpretability have not been studied.
What does this study add? This study shows good responsiveness of the HECSI. A severity grading for single scores is proposed. The smallest detectable change and minimally important change for improvement are determined.
What are the clinical implications of this work? The obtained values help to interpret HECSI scores in daily practice and clinical studies, and may facilitate researchers in the calculation of sample sizes for clinical trials.
https://www.bjdonline.com/article/ Linked Comment:https://doi.org/10.1111/bjd.18544 https://doi.org/10.1111/bjd.18911 available online
Collapse
Affiliation(s)
- J A F Oosterhaven
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - M L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
6
|
Christoffers WA, Coenraads PJ, Svensson Å, Diepgen TL, Dickinson-Blok JL, Xia J, Williams HC. Interventions for hand eczema. Cochrane Database Syst Rev 2019; 4:CD004055. [PMID: 31025714 PMCID: PMC6484375 DOI: 10.1002/14651858.cd004055.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Hand eczema is an inflammation of the skin of the hands that tends to run a chronic, relapsing course. This common condition is often associated with itch, social stigma, and impairment in employment. Many different interventions of unknown effectiveness are used to treat hand eczema. OBJECTIVES To assess the effects of topical and systemic interventions for hand eczema in adults and children. SEARCH METHODS We searched the following up to April 2018: Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, AMED, LILACS, GREAT, and four trials registries. We checked the reference lists of included studies for further references to relevant trials. SELECTION CRITERIA We included randomised controlled trials (RCTs) that compared interventions for hand eczema, regardless of hand eczema type and other affected sites, versus no treatment, placebo, vehicle, or active treatments. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Primary outcomes were participant- and investigator-rated good/excellent control of symptoms, and adverse events. MAIN RESULTS We included 60 RCTs, conducted in secondary care (5469 participants with mild to severe chronic hand eczema). Most participants were over 18 years old. The duration of treatment was short, generally up to four months. Only 24 studies included a follow-up period. Clinical heterogeneity in treatments and outcome measures was evident. Few studies performed head-to-head comparisons of different interventions. Risk of bias varied considerably, with only five studies at low risk in all domains. Twenty-two studies were industry-funded.Eighteen trials studied topical corticosteroids or calcineurin inhibitors; 10 studies, phototherapy; three studies, systemic immunosuppressives; and five studies, oral retinoids. Most studies compared an active intervention against no treatment, variants of the same medication, or placebo (or vehicle). Below, we present results from the main comparisons.Corticosteroid creams/ointments: when assessed 15 days after the start of treatment, clobetasol propionate 0.05% foam probably improves participant-rated control of symptoms compared to vehicle (risk ratio (RR) 2.32, 95% confidence interval (CI) 1.38 to 3.91; number needed to treat for an additional beneficial outcome (NNTB) 3, 95% CI 2 to 8; 1 study, 125 participants); the effect of clobetasol compared to vehicle for investigator-rated improvement is less clear (RR 1.43, 95% CI 0.86 to 2.40). More participants had at least one adverse event with clobetasol (11/62 versus 5/63; RR 2.24, 95% CI 0.82 to 6.06), including application site burning/pruritus. This evidence was rated as moderate certainty.When assessed 36 weeks after the start of treatment, mometasone furoate cream used thrice weekly may slightly improve investigator-rated symptom control compared to twice weekly (RR 1.23, 95% CI 0.94 to 1.61; 1 study, 72 participants) after remission is reached. Participant-rated symptoms were not measured. Some mild atrophy was reported in both groups (RR 1.76, 95% CI 0.45 to 6.83; 5/35 versus 3/37). This evidence was rated as low certainty.Irradiation with ultraviolet (UV) light: local combination ultraviolet light therapy (PUVA) may lead to improvement in investigator-rated symptom control when compared to local narrow-band UVB after 12 weeks of treatment (RR 0.50, 95% CI 0.22 to 1.16; 1 study, 60 participants). However, the 95% CI indicates that PUVA might make little or no difference. Participant-rated symptoms were not measured. Adverse events (mainly erythema) were reported by 9/30 participants in the narrow-band UVB group versus none in the PUVA group. This evidence was rated as moderate certainty.Topical calcineurin inhibitors: tacrolimus 0.1% over two weeks probably improves investigator-rated symptom control measured after three weeks compared to vehicle (14/14 tacrolimus versus 0/14 vehicle; 1 study). Participant-rated symptoms were not measured. Four of 14 people in the tacrolimus group versus zero in the vehicle group had well-tolerated application site burning/itching.A within-participant study in 16 participants compared 0.1% tacrolimus to 0.1% mometasone furoate but did not measure investigator- or participant-rated symptoms. Both treatments were well tolerated when assessed at two weeks during four weeks of treatment.Evidence from these studies was rated as moderate certainty.Oral interventions: oral cyclosporin 3 mg/kg/d probably slightly improves investigator-rated (RR 1.88, 95% CI 0.88 to 3.99; 1 study, 34 participants) or participant-rated (RR 1.25, 95% CI 0.69 to 2.27) control of symptoms compared to topical betamethasone dipropionate 0.05% after six weeks of treatment. The risk of adverse events such as dizziness was similar between groups (up to 36 weeks; RR 1.22, 95% CI 0.80 to 1.86, n = 55; 15/27 betamethasone versus 19/28 cyclosporin). The evidence was rated as moderate certainty.Alitretinoin 10 mg improves investigator-rated symptom control compared with placebo (RR 1.58, 95% CI 1.20 to 2.07; NNTB 11, 95% CI 6.3 to 26.5; 2 studies, n = 781) and alitretinoin 30 mg also improves this outcome compared with placebo (RR 2.75, 95% CI 2.20 to 3.43; NNTB 4, 95% CI 3 to 5; 2 studies, n = 1210). Similar results were found for participant-rated symptom control: alitretinoin 10 mg RR 1.73 (95% CI 1.25 to 2.40) and 30 mg RR 2.75 (95% CI 2.18 to 3.48). Evidence was rated as high certainty. The number of adverse events (including headache) probably did not differ between alitretinoin 10 mg and placebo (RR 1.01, 95% CI 0.66 to 1.55; 1 study, n = 158; moderate-certainty evidence), but the risk of headache increased with alitretinoin 30 mg (RR 3.43, 95% CI 2.45 to 4.81; 2 studies, n = 1210; high-certainty evidence). Outcomes were assessed between 48 and 72 weeks. AUTHORS' CONCLUSIONS Most findings were from single studies with low precision, so they should be interpreted with caution. Topical corticosteroids and UV phototherapy were two of the major standard treatments, but evidence is insufficient to support one specific treatment over another. The effect of topical calcineurin inhibitors is not certain. Alitretinoin is more effective than placebo in controlling symptoms, but advantages over other treatments need evaluating.Well-designed and well-reported, long-term (more than three months), head-to-head studies comparing different treatments are needed. Consensus is required regarding the definition of hand eczema and its subtypes, and a standard severity scale should be established.The main limitation was heterogeneity between studies. Small sample size impacted our ability to detect differences between treatments.
Collapse
Affiliation(s)
- Wietske Andrea Christoffers
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, Netherlands, 9700RB
| | | | | | | | | | | | | |
Collapse
|
7
|
Weistenhöfer W, Uter W, Bernet F, Drexler H. The tissue viability imaging system-Suitable method for discovering minimal skin changes in occupational screenings? Results of a cross-sectional field study. Skin Res Technol 2019; 25:553-563. [PMID: 30770590 DOI: 10.1111/srt.12686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/12/2019] [Accepted: 01/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND For early detection of initial skin changes in occupational screenings, only few objective assessment systems are available. OBJECTIVES With the aim of assessing an objective measurement method for hand eczema, we trialed the application of the tissue viability imaging (TiVi) system, quantifying erythema non-invasively by polarized light spectroscopy. MATERIALS AND METHODS In a field study with 625 employees of a semiconductor production company, 411 were exposed to prolonged wearing of occlusive gloves in the clean room. TiVi system and Hand Eczema Score for Occupational Screenings (HEROS), a quantitative skin score for the hands, were used, supplemented by a standardized personal interview. RESULTS TiVi values of 65 up to 246 for each hand (palm or back), for each participant summed to overall 289 up to 848 (median 389), were measured. Higher TiVi values were noted for men, smokers, and with increasing age. Correlation between TiVi and HEROS was only weak. Several factors like skin pigmentation, thickness of the skin, or tattoos seem to influence TiVi results. CONCLUSIONS The practical relevance of one-time measurements with the TiVi system in occupational screenings seems to be limited. Specifically, the TiVi system cannot replace dermatological examinations at the workplace. Notwithstanding, the application for other scientific purposes might be useful.
Collapse
Affiliation(s)
- Wobbeke Weistenhöfer
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Franziska Bernet
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Hausarztpraxis Tegernheim, Tegernheim, Germany
| | - Hans Drexler
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
8
|
Wilke A, Gediga G, Goergens A, Hansen A, Hübner A, John SM, Nordheider K, Rocholl M, Weddeling S, Wulfhorst B, Nashan D. Interdisciplinary and multiprofessional outpatient secondary individual prevention of work-related skin diseases in the metalworking industry: 1-year follow-up of a patient cohort. BMC DERMATOLOGY 2018; 18:12. [PMID: 30541516 PMCID: PMC6292163 DOI: 10.1186/s12895-018-0080-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 11/30/2018] [Indexed: 11/10/2022]
Abstract
Background In Germany, work-related skin diseases are predominant within the spectrum of reported occupational diseases. Metal workers are among the high-risk professions. Offering effective prevention programs to affected patients is of utmost importance to avoid deterioration of the disease and job loss. We conducted a 1-year follow-up in patients who participated in a multidisciplinary, complex outpatient prevention program representing a standard procedure of patient care by the respective statutory accident insurance. Methods The multi-component prevention program consists of multiprofessional individual patient counseling, a structured skin protection seminar in a group, as well as workplace visits and on-site counseling in terms of appropriate skin protection (e.g. gloves). An observational study with a 1-year follow-up and four measurements (T1-T4, longitudinal pre/post-test design) including dermatological examinations and standardized written questionnaires was conducted between 2013 and 2016 to assess changes over time regarding job loss and disease severity. Results Data from 94 patients (87 male, mean age: 45.4 years) were included in the analysis. One year after the skin protection seminar (T4), 83 patients (88.3%) remained in their original professional metalworking activity and four patients (4.3%) had given up their profession because of their skin disease. At baseline (T1), irritant contact dermatitis of the hands was the most frequent diagnosis (80.7%). Methods for self-reported disease severity showed good correlation with the clinical gold standard at T1 and T2 (dermatological examination with the Osnabrück Hand Eczema Severity Index / OHSI), and a significant decrease of the self-reported disease severity was found over time from T1 to T4 (p < 0.001). Further results indicate an improved self-perceived disease control and an overall satisfaction with the prevention program. Conclusions The results of this observational study demonstrate that the comprehensive prevention program positively influences the course of work-related skin diseases, increases the possibility to continue working in a “high-risk” profession and improves the disease management of metal workers. In the long term, the prevention program may lead to cost savings by preventing high therapy costs or professional retraining. Electronic supplementary material The online version of this article (10.1186/s12895-018-0080-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Annika Wilke
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany. .,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.
| | - Günther Gediga
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Andreas Goergens
- German Social Accident Insurance Institution for the woodworking and metalworking industries, district administration in Dortmund, Semerteichstraße 98, 44263, Dortmund, Germany
| | - Andreas Hansen
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Anja Hübner
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Kathrin Nordheider
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Sabine Weddeling
- Department of Dermatology, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Germany
| | - Britta Wulfhorst
- Faculty of Human Sciences/Department of Educational Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Dorothée Nashan
- Department of Dermatology, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Germany
| |
Collapse
|
9
|
Mpofana N, Abrahamse H. The Management of Melasma on Skin Types V and VI Using Light Emitting Diode Treatment. Photomed Laser Surg 2018; 36:522-529. [PMID: 30227084 DOI: 10.1089/pho.2018.4486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study investigated light emitting diode (LED) treatment for patients with melasma on darker skin types. BACKGROUND Melasma is a common disfiguring skin condition in women which is difficult to treat and is refractory. The cause of melasma remains unclear. METHODS In this study, 60 female participants aged between 25 and 60 years, who presented with melasma, were enrolled (n = 39.85). They were purposely assigned to two groups according to their skin types. Both groups received a total of 36 LED light treatments over a period of 9 months. RESULTS Both subjective and objective results indicated a significant improvement of melasma. Statistical analyses revealed significant improvements in both groups. CONCLUSIONS The results of this study suggest that LED is effective in managing melasma. These results will provide a basis for future therapeutic use of phototherapy to improve melasma.
Collapse
Affiliation(s)
- Nomakhosi Mpofana
- 1 Wellness Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology , Zonnebloem, South Africa
| | - Heidi Abrahamse
- 2 Faculty of Health Sciences, Laser Research Centre, University of Johannesburg , Doornfontein, South Africa
| |
Collapse
|
10
|
Ribet V, Mielewczyk E, Sirvent A, Georgescu V, Rossi AB. A novel dermo-cosmetic product containing thermal spring water, sucralfate, copper sulfate, and zinc sulfate in the management of hand eczema. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2018; 11:373-381. [PMID: 30038513 PMCID: PMC6053173 DOI: 10.2147/ccid.s157849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background The regular use of cosmetic products plays a role in the management of hand eczema (HE) and aids in improving barrier function reducing dryness, roughness, pruritus and improving quality of life (QoL). The aim of this open-label study was to assess the efficacy and the reparative effect of a dermo-cosmetic product on subjects suffering from HE after 7 and 21 days of daily application. Methods The product was a water-in-oil (W/O) emulsion containing the active ingredients Avène thermal spring water, sucralfate, and copper and zinc sulfates. In total, 32 subjects suffering from either contact dermatitis or climatic dermatitis participated in the trial. The modified total lesion symptom score and physician global assessment scores were used to describe the severity of HE. The safety of the product was assessed through clinical scoring. The subjective tolerance, and acceptance, were documented using a self-assessment questionnaire completed by the subjects. The impact of the dermatosis on QoL was evaluated using the Dermatology Life Quality Index. Results After 7 days of application, both the physician and subjects noticed a significant improvement in HE. The formula was very well tolerated and accepted. These benefits were correlated with a significant improvement in QoL. Conclusion The W/O emulsion used in this study demonstrated real benefits for the subjects suffering from contact dermatitis and climatic dermatitis.
Collapse
Affiliation(s)
- Virginie Ribet
- Clinical Development Department, Pierre Fabre Dermo-Cosmetics, Toulouse, France,
| | | | | | - Victor Georgescu
- Medical Department, Laboratoires Dermatologiques Avène, Lavaur, France
| | - Ana Beatris Rossi
- Clinical Development Department, Pierre Fabre Dermo-Cosmetics, Toulouse, France,
| |
Collapse
|
11
|
Oosterhaven JAF, Schuttelaar MLA, Apfelbacher C, Diepgen TL, Ofenloch RF. Guideline for translation and national validation of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ). Contact Dermatitis 2017; 77:106-115. [PMID: 28481015 DOI: 10.1111/cod.12788] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/23/2017] [Accepted: 02/06/2017] [Indexed: 11/28/2022]
Abstract
There is a need for well-developed and validated questionnaires to measure patient reported outcomes. The Quality of Life in Hand Eczema Questionnaire (QOLHEQ) is such a validated instrument measuring disease-specific health-related quality of life in hand eczema patients. A re-validation of measurement properties is required before an instrument is used in a new population. With the objective of arriving at a guideline for translation and national validation of the QOLHEQ, we have developed the design of a reference study on how to adequately assess measurement properties of the QOLHEQ based on interdisciplinary discussions and current standards. We present a step-by-step guideline to assess translation (including cross-cultural adaptation), scale structure, validity, reproducibility, responsiveness, and interpretability. We describe which outcomes should be reported for each measurement property, and give advice on how to calculate these. It is also specified which sample size is needed, how to deal with missing data, and which cutoff values should be applied for the measurement properties assessed during the validation process. In conclusion, this guideline, presenting a reference validation study for the QOLHEQ, creates the possibility to harmonize the national validation of the various language versions of the QOLHEQ.
Collapse
Affiliation(s)
- Jart A F Oosterhaven
- Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands
| | - Christian Apfelbacher
- Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, 93053, Regensburg, Germany
| | - Thomas L Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, 69115, Heidelberg, Germany
| | - Robert F Ofenloch
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, 69115, Heidelberg, Germany
| |
Collapse
|
12
|
Smith IL, Brown S, Nixon J, Cowdell FC, Ersser S, Fernandez C, Goodfield M, Green CM, Hampton P, Lear JT, Smith CH, Sunderland L, Tubeuf S, Wittmann M. Treatment of severe, chronic hand eczema: results from a UK-wide survey. Clin Exp Dermatol 2016; 42:185-188. [PMID: 27910127 DOI: 10.1111/ced.13015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2016] [Indexed: 11/30/2022]
Abstract
Treatment of severe hand eczema (HE) that is resistant to topical potent corticosteroid treatment is challenging. In 2013, we surveyed 194 UK dermatologists to obtain information about their usual treatment pathways to inform the choice of the comparator in a trial of alitretinoin in severe HE (ALPHA trial); the results indicated that the treatment approaches favoured by UK dermatologists differ. Psoralen combined with ultraviolet A (PUVA) and alitretinoin were identified as the most frequent first-line treatment options for hyperkeratotic HE, whereas oral corticosteroids were identified as the most frequent first-line treatment for vesicular HE, followed by PUVA and alitretinoin. In terms of potential adverse effects of long-term or repeated use, oral steroids and ciclosporin A were reported to cause most concern. There is uncertainty about which treatment gives the best short and long-term outcomes, because of a lack of definitive randomised controlled trials evaluating the effectiveness of different treatment pathways in severe HE.
Collapse
Affiliation(s)
- I L Smith
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, Yorkshire, UK
| | - S Brown
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, Yorkshire, UK
| | - J Nixon
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, Yorkshire, UK
| | - F C Cowdell
- Faculty of Health Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - S Ersser
- School of Healthcare, University of Leeds, Leeds, Yorkshire, UK
| | - C Fernandez
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, Yorkshire, UK
| | - M Goodfield
- Department of Dermatology, Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, UK
| | - C M Green
- Department of Dermatology, Ninewells Hospital, Dundee, Tayside, UK
| | - P Hampton
- Department of Dermatology, Newcastle Hospitals, Newcastle, Tyne and Wear, UK
| | - J T Lear
- Department of Dermatology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - C H Smith
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - S Tubeuf
- Academic Unit of Health Economics, University of Leeds, Leeds, Yorkshire, UK
| | - M Wittmann
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, Yorkshire, UK.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, Yorkshire, UK.,Department of Dermatology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, Yorkshire, UK
| |
Collapse
|
13
|
Occupational dermal exposure to nanoparticles and nano-enabled products: Part I—Factors affecting skin absorption. Int J Hyg Environ Health 2016; 219:536-44. [DOI: 10.1016/j.ijheh.2016.05.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/25/2016] [Accepted: 05/26/2016] [Indexed: 11/23/2022]
|
14
|
Majid I, Haq I, Imran S, Keen A, Aziz K, Arif T. Proposing Melasma Severity Index: A New, More Practical, Office-based Scoring System for Assessing the Severity of Melasma. Indian J Dermatol 2016; 61:39-44. [PMID: 26955093 PMCID: PMC4763693 DOI: 10.4103/0019-5154.174024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Melasma Area and Severity Index (MASI), the scoring system in melasma, needs to be refined. Aims and Objectives: To propose a more practical scoring system, named as Melasma Severity Index (MSI), for assessing the disease severity and treatment response in melasma. Materials and Methods: Four dermatologists were trained to calculate MASI and also the proposed MSI scores. For MSI, the formula used was 0.4 (a × p2) l + 0.4 (a × p2) r + 0.2 (a × p2) n where “a” stands for area, “p” for pigmentation, “l” for left face, “r” for right face, and “n” for nose. On a single day, 30 enrolled patients were randomly examined by each trained dermatologist and their MASI and MSI scores were calculated. Next, each rater re-examined every 6th patient for repeat MASI and MSI scoring to assess intra- and inter-rater reliability of MASI and MSI scores. Validity was assessed by comparing the individual scores of each rater with objective data from mexameter and ImageJ software. Results: Inter-rater reliability, as assessed by intraclass correlation coefficient, was significantly higher for MSI (0.955) as compared to MASI (0.816). Correlation of scores with objective data by Spearman's correlation revealed higher rho values for MSI than for MASI for all raters. Limitations: Sample population belonged to a single ethnic group. Conclusions: MSI is simpler and more practical scoring system for melasma.
Collapse
Affiliation(s)
- Imran Majid
- Department of Dermatology, CUTIS Institute of Dermatology, Srinagar, Jammu and Kashmir, India
| | - Inaamul Haq
- Department of Social and Preventive Medicine, GMC Srinagar, Srinagar, Jammu and Kashmir, India
| | - Saher Imran
- Department of Dermatology, CUTIS Institute of Dermatology, Srinagar, Jammu and Kashmir, India
| | - Abid Keen
- Department of Health, J&K Health Services, Srinagar, Jammu and Kashmir, India
| | - Khalid Aziz
- Department of Health, J&K Health Services, Srinagar, Jammu and Kashmir, India
| | - Tasleem Arif
- Department of Health, J&K Health Services, Srinagar, Jammu and Kashmir, India
| |
Collapse
|
15
|
Shroff A, Malajian D, Czarnowicki T, Rose S, Bernstein DM, Singer GK, Lebwohl MG, Hadi S, Guttman-Yassky E. Use of 308 nm excimer laser for the treatment of chronic hand and foot eczema. Int J Dermatol 2016; 55:e447-53. [PMID: 26917041 DOI: 10.1111/ijd.13205] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/03/2015] [Accepted: 09/22/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chronic hand and foot eczema (CHFE), a prevalent debilitating disorder affecting approximately 15% of the population, presents a socioeconomic and psychosocial burden for patients and often follows a chronic course, refractory to conventional therapies. Thus, a large need exists for more effective therapeutics; the excimer laser (308 nm) is effective for some inflammatory skin diseases, but its efficacy has not been evaluated for CHFE. METHODS The study is a retrospective chart review conducted on 30 patients with recalcitrant CHFE (19 with hand involvement, four with foot involvement, and seven with both) treated twice weekly with excimer laser (308 nm) single wavelength ultraviolet (UV)B radiation between January 2013 and December 2014. RESULTS Improvements in clinical scores included a 69% reduction in average physician's global assessment (PGA) scores (from 2.77 at baseline to 0.87 after treatment, P < 0.0001) with a parallel reduction in average modified total lesion/symptom scores of 70% (from 10.2 to 3.1, P < 0.0001). Only mild sunburn-like reactions were observed. CONCLUSION This report evaluates excimer laser for patients with refractory CHFE and shows excellent and sustained efficacy for this treatment. Compared to other UV therapies, excimer laser offers lower cumulative doses of UV radiation by targeting specific areas. This effective treatment should be considered alone or in combination with other established or newer therapies.
Collapse
Affiliation(s)
- Anjali Shroff
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dana Malajian
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA.,College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Tali Czarnowicki
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - Sharon Rose
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel M Bernstein
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giselle K Singer
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Suhail Hadi
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| |
Collapse
|
16
|
Grönhagen C, Lidén C, Bergström A, Kull I, Wahlgren C, Meding B. Prevalence and incidence of hand eczema in adolescence: report from
BAMSE
– a population‐based birth cohort. Br J Dermatol 2014; 171:609-14. [DOI: 10.1111/bjd.13194] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2014] [Indexed: 12/01/2022]
Affiliation(s)
- C.M. Grönhagen
- Institute of Environmental Medicine Karolinska Institutet Stockholm SE‐171 77 Sweden
| | - C. Lidén
- Institute of Environmental Medicine Karolinska Institutet Stockholm SE‐171 77 Sweden
| | - A. Bergström
- Institute of Environmental Medicine Karolinska Institutet Stockholm SE‐171 77 Sweden
| | - I. Kull
- Institute of Environmental Medicine Karolinska Institutet Stockholm SE‐171 77 Sweden
- Department of Clinical Science and Education Stockholm South General Hospital Karolinska Institutet and Sachs' Children's Hospital Stockholm Sweden
| | - C.‐F. Wahlgren
- Dermatology Unit Department of Medicine Solna Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - B. Meding
- Institute of Environmental Medicine Karolinska Institutet Stockholm SE‐171 77 Sweden
| |
Collapse
|
17
|
|
18
|
Lindberg M, Bingefors K, Meding B, Berg M. Hand eczema and health-related quality of life; a comparison of EQ-5D and the Dermatology Life Quality Index (DLQI) in relation to the hand eczema extent score (HEES). Contact Dermatitis 2013; 69:138-43. [DOI: 10.1111/cod.12067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/15/2013] [Accepted: 01/16/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - Kerstin Bingefors
- Department of Pharmacy; Uppsala University; SE-751 05; Uppsala; Sweden
| | | | | |
Collapse
|
19
|
van der Valk PGM, van Gils RF, Boot CRL, Evers AWM, Donders R, Alkemade HAC, Coenraads PJ, Rustemeyer T, van Mechelen W, Anema JR. A simple tool with which to study the course of chronic hand eczema in clinical practice: a reduced-item score. Contact Dermatitis 2013; 69:112-7. [DOI: 10.1111/cod.12041] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
20
|
|
21
|
Abstract
Background Hand eczema is a disease frequently observed in dermatological practice. This condition has negative emotional, social, and psychological effects due to its impact on daily life and morphological appearance. Due to its considerable effect on the quality of life, this disease can lead to depression. However, not many studies have been performed on the quality of life and depression in hand eczema patients. Objective The purpose of this study is to investigate the association between the quality of life, depression, and disease severity in hand eczema patients in South Korea. Methods A total of 138 patients with hand eczema participated in this study. The patients' quality of life was assessed by a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Data on patients suffering from depression was obtained using the Beck's Depression Inventory (BDI-II). The disease severity was determined during the clinical examination, according to the Hand Eczema Severity Index (HECSI). Results We found positive associations between DLQI and HECSI scores (p<0.05). BDI-II scores had also statistically positive correlations with HECSI scores (p<0.05). DLQI and BDI-II scores both increased with disease severity. Conclusion Hand eczema negatively affected the quality of life and mood of patients relative to the disease severity. Therefore, we suggest that quality of life modification and emotional support should be included as a part of treatment for hand eczema.
Collapse
Affiliation(s)
- Mi Yu
- Department of Dermatology, Eulji General Hospital, College of Medicine, Eulji University, Seoul, Korea
| | | | | | | |
Collapse
|
22
|
Abstract
Hand eczema is an inflammation of the skin; the cause is often multifactorial. Initial management includes avoiding causative irritants or allergens (e.g., by wearing impermeable gloves) and applying emollients and potent topical glucocorticoids.
Collapse
Affiliation(s)
- Pieter-Jan Coenraads
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| |
Collapse
|
23
|
Schuttelaar MLA, Coenraads PJ, Huizinga J, De Monchy JG, Vermeulen KM. Increase in vesicular hand eczema after house dust mite inhalation provocation: a double-blind, placebo-controlled, cross-over study. Contact Dermatitis 2012; 68:76-85. [DOI: 10.1111/j.1600-0536.2012.02172.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
24
|
Luk NMT, Lee HCS, Luk CKD, Cheung YYA, Chang MC, Chao VKD, Ng SC, Tang LSN. Hand eczema among Hong Kong nurses: a self-report questionnaire survey conducted in a regional hospital. Contact Dermatitis 2011; 65:329-35. [DOI: 10.1111/j.1600-0536.2011.01961.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
25
|
|
26
|
Carlsson A, Gånemo A, Anderson C, Meding B, Stenberg B, Svensson Å. Scoring of hand eczema: good agreement between patients and dermatological staff. Br J Dermatol 2011; 165:123-8. [DOI: 10.1111/j.1365-2133.2011.10312.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Weistenhöfer W, Baumeister T, Drexler H, Kütting B. How to quantify skin impairment in primary and secondary prevention? HEROS: a proposal of a hand eczema score for occupational screenings. Br J Dermatol 2011; 164:807-13. [DOI: 10.1111/j.1365-2133.2010.10181.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
28
|
Baumeister T, Weistenhöfer W, Drexler H, Kütting B. Spoilt for choice - evaluation of two different scoring systems for early hand eczema in teledermatological examinations. Contact Dermatitis 2010; 62:241-7. [DOI: 10.1111/j.1600-0536.2010.01703.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|