Fifteen-year follow-up of hand eczema: persistence and consequences.
BACKGROUND
Hand eczema is a skin disease often with a long-lasting and relapsing course. The long-term prognosis in the general population is unknown.


OBJECTIVE
The aims were to examine the extent to which hand eczema had persisted and the medicosocial consequences of the disease.


METHODS
In a 15-year follow-up of hand eczema, patients diagnosed in a previous population-based study were sent a questionnaire with 20 questions concerning the persistence and course of the disease, and its occupational and medicosocial consequences.


RESULTS
Addresses were available for 1115 persons, of whom 868 answered the questionnaire. Sixty-six per cent of the respondents reported periods of hand eczema and 44% reported symptoms during the previous year, with no sex difference. Twelve per cent reported continuous eczema. However, 74% of those reporting symptoms considered that their hand eczema had improved; of these more were women than men (78% vs. 66%, P < 0.01). Twenty people, 3% of those who were gainfully employed in 1983, reported a change to another occupation because of their hand eczema, 15 of these reporting improvement after the job change. A considerable need for medical consultation was reported, as was the influence on psychosocial functions among those who had eczema the previous year, e.g. sleep disturbances (36%) and hampered leisure activities (72%). Job changes related to hand eczema and psychosocial impairment were also reported by individuals who had not sought medical help for their hand eczema.


CONCLUSIONS
This study demonstrates a variable and poor long-term prognosis for hand eczema in the general population. One-third sought medical care during follow-up, while the vast majority with ongoing hand eczema experienced negative psychosocial consequences. For about 5%, the hand eczema gave far-reaching consequences including long sick-leave periods, sick pension and changes of occupation.
Meding
B
B
Occupational and Environmental Dermatology, Department of Medicine, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden. birgitta.meding@niwl.se
Wrangsjö
K
K
Järvholm
B
B
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006229:Hand Dermatoses / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011379:Prognosis; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology