Medical consultations in relation to severity of hand eczema in the general population.
BACKGROUND
Hand eczema is a common disease with a wide severity spectrum. Little information exists concerning the association between the severity of hand eczema and medical consultations.


OBJECTIVE
To describe the self-rated severity of hand eczema in a general population and the relationship to seeking medical attention.


METHODS
A questionnaire on self-reported hypersensitivity including two questions on hand eczema was sent to a random sample of 6000 individuals, aged 18-69 years, living in Copenhagen, Denmark. A total of 4242 individuals (71%) answered the questionnaire. All individuals who reported hand eczema (n = 752) within the previous 12 months received a more detailed questionnaire focused on hand eczema and a previously validated photographic guide with four groups of severity ranging from almost clear to very severe.


RESULTS
Five hundred and sixty-four individuals (75%) returned the second questionnaire. The 1-year period prevalence of hand eczema was estimated to be 14% in the population. Twenty-three per cent rated their hand eczema as moderate to very severe. In total, 67% had consulted their general practitioner and 44% had consulted a dermatologist because of hand eczema. Multivariate analysis showed a positive association (P < 0.05) between severity of hand eczema and medical consultations. Of those individuals (n = 102) who had not consulted a dermatologist 26% had experienced moderate to very severe hand eczema within the previous 12 months.


CONCLUSIONS
A considerable proportion of individuals with moderate to very severe hand eczema in the general population miss out on the potential benefit of a dermatological examination, patch testing and a thorough-going exploration of environmental factors.
Hald
M
M
National Allergy Research Centre, Department of Dermatology, Gentofte Hospital, University of Copenhagen, Niels Andersens vej 65, 2900 Hellerup, Denmark.
Berg
N D
ND
Elberling
J
J
Johansen
J D
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006229:Hand Dermatoses / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000592:standards*; D012720:Severity of Illness Index