title: Contact sensitisation in hand eczema patients-relation to subdiagnosis, severity and quality of life: a multi-centre study.
abstract: BACKGROUND
  Contact sensitisation has been identified as a factor associated with poor prognosis for patients with hand eczema.
  
  
  OBJECTIVE
  To study implications of contact sensitisation with respect to severity, quality of life (QoL) and subdiagnosis of hand eczema.
  
  
  METHODS
  The study was performed as a multi-centre, cross-sectional study from 10 European clinics. All patients were patch tested, and severity of hand eczema assessed by Hand Eczema Severity Index. A multi-variate analysis was performed to explore which factors influenced severity, QoL and sick leave.
  
  
  RESULTS
  A total 416 patients were included, and 63% had contact sensitisation to one or more of the tested allergens. More women (66%) than men (51%) were sensitized. No significant association was found between sensitisation to specific allergens, disease severity, QoL or diagnostic subgroups. High age, male sex, atopic eczema and presence of contact sensitisation were independent risk factors for increased severity as measured by Hand Eczema Severity Index. Furthermore, the severity of hand eczema increased by the number of contact sensitisations detected (P = 0.023). High age and personal history of atopic eczema were independent risk factors for low QoL, as measured by Dermatology Life Quality Index, and atopic eczema as well as allergic contact dermatitis as subdiagnosis was associated with increased sick leave.
  
  
  CONCLUSIONS
  Diagnostic subgroups were not found to be related to specific allergens. Contact sensitisation was found to be a risk factor for increased severity of hand eczema, as did high age, male sex and atopic eczema.
authors.affiliation: Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark. t.agner@dadlnet.dk
authors.forename: Tove
authors.initials: T
authors.lastname: Agner
authors.forename: Klaus Ejner
authors.initials: KE
authors.lastname: Andersen
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Brandao
authors.forename: Derk P
authors.initials: DP
authors.lastname: Bruynzeel
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
authors.forename: Peter
authors.initials: P
authors.lastname: Frosch
authors.forename: Margarida
authors.initials: M
authors.lastname: Gonçalo
authors.forename: An
authors.initials: A
authors.lastname: Goossens
authors.forename: Christophe J
authors.initials: CJ
authors.lastname: Le Coz
authors.forename: Thomas
authors.initials: T
authors.lastname: Rustemeyer
authors.forename: Ian R
authors.initials: IR
authors.lastname: White
authors.forename: Thomas
authors.initials: T
authors.lastname: Diepgen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003877:Dermatitis, Contact / Q000453:epidemiology* / Q000523:psychology; D004485:Eczema / Q000453:epidemiology* / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006229:Hand Dermatoses / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D018582:Sick Leave