Contact sensitisation in hand eczema patients-relation to subdiagnosis, severity and quality of life: a multi-centre study.
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.
Agner
Tove
T
Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark. t.agner@dadlnet.dk
Andersen
Klaus Ejner
KE
Brandao
Francisco M
FM
Bruynzeel
Derk P
DP
Bruze
Magnus
M
Frosch
Peter
P
Gonçalo
Margarida
M
Goossens
An
A
Le Coz
Christophe J
CJ
Rustemeyer
Thomas
T
White
Ian R
IR
Diepgen
Thomas
T
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