title: Which factors are associated with the use of systemic antihistamines in patients with chronic hand eczema? Results from the CARPE registry.
abstract: BACKGROUND
  Antihistamines (AH) are often used to treat chronic skin diseases related to allergy and/or pruritus. Data on the use of AH in patients with chronic hand eczema (CHE) is scarce.
  
  
  OBJECTIVE
  The objective of this study was to investigate prevalence and determinants of AH use in patients with CHE.
  
  
  METHODS
  Data were drawn from the German CARPE registry. The relationship of clinical, demographic and treatment-related variables with AH use in the past 12 months was analysed by means of logistic regression. Odds ratios (OR) with corresponding 95% confidence intervals (CIs) were computed.
  
  
  RESULTS
  A total of 1255 patients with CHE were eligible for analysis (54.1% female; mean age: 47.1 years, standard deviation (SD) 13.6 years). Mean subjective disease severity was 5.0 (SD 2.5). 25% of the sample reported to have used AH in the past 12 months. Significant positive associations with AH use were identified for moderate (OR = 3.05, 95% CI 1.81-5.15) or severe (OR = 4.27, 95% CI 2.40-7.59) pruritus, a history of systemic treatment (e.g. alitretinoin) (OR = 2.85, 95% CI: 2.06-3.96), UV phototherapy (OR = 1.78, 95% CI 1.28-2.46), flexural eczema (OR = 1.89, 95% CI 1.32-2.71), allergic rhinitis/conjunctivitis (OR = 2.41, 95% CI 1.71-3.39) and female gender (OR = 1.58, 95% CI 1.16-2.14) in multivariate analyses (N = 1184). Significant inverse associations were found for an eczema localization besides the hands (OR = 0.66, 95% CI 0.46-0.94) and for patients being recruited in hospital (vs. dermatological practice; OR = 0.47, 95% CI 0.33-0.67).
  
  
  CONCLUSIONS
  This study suggests that AH use is frequent in patients with CHE and mainly related to female gender, disease severity, pruritus, comorbid atopic disease and treatment centre.
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Apfelbacher
authors.affiliation: Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital, Ruprecht Karls University Heidelberg, Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Weiß
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Molin
authors.affiliation: Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.|University Allergy Center (UAC), University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bauer
authors.affiliation: Department of Dermatology, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen, Erlangen, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Mahler
authors.affiliation: University Allergy Center (UAC), University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.|Centre for Evidence-based Healthcare, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schmitt
authors.affiliation: Department of Dermatology and Dermatological Allergy, Friedrich-Schiller-University Jena, Jena, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Elsner
authors.affiliation: Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital, Ruprecht Karls University Heidelberg, Heidelberg, Germany.
authors.forename: T L
authors.initials: TL
authors.lastname: Diepgen
authors.affiliation: Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital, Ruprecht Karls University Heidelberg, Heidelberg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Weisshaar
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D015897:Comorbidity; D004485:Eczema / Q000188:drug therapy*; D005260:Female; D005858:Germany; D006229:Hand Dermatoses / Q000188:drug therapy*; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D006633:Histamine Antagonists