title: Hand eczema—prognosis and consequences: a 7-year follow-up study.
abstract: BACKGROUND
  Hand eczema is recognized as a long-lasting disease with personal and societal repercussions. Long-term studies are required to generate information on factors contributing to a poor outcome.
  
  
  OBJECTIVE
  The aims of this 7-year follow-up study were to evaluate the clinical course of patients with hand eczema, the occupational consequences and to identify risk factors associated with a poor prognosis.
  
  
  METHODS
  In all, 536 patients with hand eczema participated and were examined by a dermatologist. The clinical severity was assessed at baseline and 7 years later using a self-administrated photographic guide. Additional information was obtained from a questionnaire.
  
  
  RESULTS
  Based on the photographic guide, 73% experienced a clinical improvement. Notably, 20% had moderate to very severe hand eczema at follow-up. Severe hand eczema or frequent eruptions at baseline and eczema in other body locations during the follow-up period were risk factors of a poor prognosis. The same factors, as well as being a woman, were associated with occupational consequences and low health-related quality of life. Of those with persistent hand eczema only 40% had visited a dermatologist during the follow-up period and 7% had oral treatment.
  
  
  CONCLUSIONS
  The disease had improved 7 years later; nevertheless, many patients continued to have considerable symptoms. Patients with a greater risk of a poor outcome are characterized by frequent eruptions, severe hand eczema and more widespread eczema. It should be questioned if more aggressive therapy and closer medical follow-up would be beneficial.
authors.affiliation: National Allergy Research Centre, Copenhagen University Hospital Gentofte, Kildegaardsvej 28, DK-2900, Hellerup, Denmark.
authors.forename: A H
authors.initials: AH
authors.lastname: Petersen
authors.forename: J D
authors.initials: JD
authors.lastname: Johansen
authors.forename: M
authors.initials: M
authors.lastname: Hald
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D004485:Eczema / Q000453:epidemiology / Q000628:therapy*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006229:Hand Dermatoses / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult