title: Medical consultations in relation to severity of hand eczema in the general population.
abstract: 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.
authors.affiliation: National Allergy Research Centre, Department of Dermatology, Gentofte Hospital, University of Copenhagen, Niels Andersens vej 65, 2900 Hellerup, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Hald
authors.forename: N D
authors.initials: ND
authors.lastname: Berg
authors.forename: J
authors.initials: J
authors.lastname: Elberling
authors.forename: J D
authors.initials: JD
authors.lastname: Johansen
mesh_terms: 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