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Soltanipoor M, Kezic S, Sluiter JK, Rustemeyer T. The effectiveness of a skin care program for the prevention of contact dermatitis in health care workers (the Healthy Hands Project): study protocol for a cluster randomized controlled trial. Trials 2017; 18:92. [PMID: 28245835 PMCID: PMC5331718 DOI: 10.1186/s13063-017-1803-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 01/18/2017] [Indexed: 11/16/2022] Open
Abstract
Background Health care workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to frequent exposure to ‘wet work’. Amongst HCWs, nurses are at highest risk, with an estimated point prevalence of HD ranging between 12 and 30%. The burden of disease is high with chronicity, sick leave, risk of unemployment and impaired quality of life. Despite evidence from the medical literature on the risk factors and the importance of skin care in the prevention of HD, in practice, compliance to skin care protocols are below 30%. New preventive strategies are obviously needed. Methods/design This is a cluster randomized controlled trial, focusing on nurses performing wet work. In total, 20 wards are recruited to include 504 participating nurses in the study at baseline. The wards will be randomized to an intervention or a control group and followed up for 18 months. The intervention consists of the facilitation of creams being available at the wards combined with the continuous electronic monitoring of their consumption with regular feedback on skin care performance in teams of HCWs. Both the intervention and the control group receive basic education on skin protection (as ‘care as usual’). Every 6 months, participants of both groups will fill in the questionnaires regarding exposure to wet work and skin protective behavior. Furthermore, skin condition will be assessed and samples of the stratum corneum collected. The effect of the intervention will be measured by comparing the change in Hand Eczema Severity Index (HECSI score) from baseline to 12 months. The Natural Moisturizing Factor (NMF) levels, measured in the stratum corneum as an early biomarker of skin barrier damage, and the total consumption of creams per ward will be assessed as a secondary outcome. Discussion This trial will assess the clinical effectiveness of an intervention program to prevent hand dermatitis among health care workers Trial registration Netherlands Trial Register (NTR), identification number NTR5564. Registered on 2 November 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1803-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maryam Soltanipoor
- Department of Dermatology, VU University Medical Centre (VUmc), De Boelelaan 1117, Amsterdam, 1081HV, The Netherlands. .,Coronel Institute of Occupational Health, Academic Medical Center (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - Sanja Kezic
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Judith K Sluiter
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, VU University Medical Centre (VUmc), De Boelelaan 1117, Amsterdam, 1081HV, The Netherlands
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Augustin M, Thaçi D, Kamps A. Der Einfluss von Alitretinoin auf die Lebensqualität bei Patienten mit schwerem chronischen Handekzem: FUGETTA - Beobachtungsstudie unter Praxisbedingungen. J Dtsch Dermatol Ges 2016; 14:1261-1272. [PMID: 27992125 DOI: 10.1111/ddg.12870_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 08/31/2015] [Indexed: 11/27/2022]
Abstract
HINTERGRUND UND ZIELE Alitretinoin ist die einzige zugelassene Behandlung für schweres chronisches Handekzem (CHE), das refraktär gegenüber potenten topischen Corticosteroiden ist. Bei dieser Studie (FUGETTA) wurde die Wirksamkeit von leitliniengerecht angewendetem oralem Alitretinoin sowie dessen Einfluss auf die Lebensqualität (LQ) bei Patienten mit schwerem refraktärem CHE beurteilt. PATIENTEN UND METHODEN Multizentrische, offene, nichtinterventionelle Beobachtungsstudie, durchgeführt in Deutschland. Die Patienten wurden nach Ermessen ihres behandelnden Arztes mit Alitretinoin 10 mg oder 30 mg einmal täglich über maximal 24 Wochen behandelt. Die Wirksamkeit wurde anhand des Physician Global Assessment (PGA) und des Dermatology Life Quality Index (DLQI) bewertet. Zudem wurden unerwünschte Ereignisse (UE) erfasst. ERGEBNISSE Die Studienpopulation bestand aus 658 Patienten (30 mg: n = 581; 10 mg: n = 77). Bei Beobachtungsbeginn litten die meisten Patienten (83 %) gemäß PGA an einem schweren CHE. Bei Beobachtungsende war das Handekzem bei 48 % der Patienten gemäß PGA vollständig oder fast vollständig abgeheilt (30 mg: 49 %; 10 mg: 43 %). Die mittlere Verbesserung des DLQI-Scores in Woche 24 betrug 58 % (30 mg: mittlere [SD] Veränderung gegenüber dem Ausgangswert -10,4 [8,04]) und 70 % (10 mg: mittlere [SD] Veränderung gegenüber dem Ausgangswert -10,8 [7,29]). Die Gesamtinzidenz von NW war niedrig und in den beiden Gruppen ähnlich. SCHLUSSFOLGERUNGEN Alitretinoin führte zu einer schnellen, deutlichen Verbesserung der LQ bei Patienten mit schwerem CHE.
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Affiliation(s)
| | - Diamant Thaçi
- Zentrum für Entzündungsmedizin, Universität zu Lübeck, Deutschland
| | - Anja Kamps
- Stiefel, ein GSK-Unternehmen, München, Deutschland
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Augustin M, Thaçi D, Kamps A. Impact on quality of life of alitretinoin in severe chronic hand eczema: FUGETTA real-world study. J Dtsch Dermatol Ges 2016; 14:1261-1270. [DOI: 10.1111/ddg.12870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 08/31/2015] [Indexed: 11/27/2022]
Affiliation(s)
| | - Diamant Thaçi
- Comprehensive Center for Inflammation Medicine; University of Luebeck; Germany
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Smith IL, Brown S, Nixon J, Cowdell FC, Ersser S, Fernandez C, Goodfield M, Green CM, Hampton P, Lear JT, Smith CH, Sunderland L, Tubeuf S, Wittmann M. Treatment of severe, chronic hand eczema: results from a UK-wide survey. Clin Exp Dermatol 2016; 42:185-188. [PMID: 27910127 DOI: 10.1111/ced.13015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2016] [Indexed: 11/30/2022]
Abstract
Treatment of severe hand eczema (HE) that is resistant to topical potent corticosteroid treatment is challenging. In 2013, we surveyed 194 UK dermatologists to obtain information about their usual treatment pathways to inform the choice of the comparator in a trial of alitretinoin in severe HE (ALPHA trial); the results indicated that the treatment approaches favoured by UK dermatologists differ. Psoralen combined with ultraviolet A (PUVA) and alitretinoin were identified as the most frequent first-line treatment options for hyperkeratotic HE, whereas oral corticosteroids were identified as the most frequent first-line treatment for vesicular HE, followed by PUVA and alitretinoin. In terms of potential adverse effects of long-term or repeated use, oral steroids and ciclosporin A were reported to cause most concern. There is uncertainty about which treatment gives the best short and long-term outcomes, because of a lack of definitive randomised controlled trials evaluating the effectiveness of different treatment pathways in severe HE.
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Affiliation(s)
- I L Smith
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, Yorkshire, UK
| | - S Brown
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, Yorkshire, UK
| | - J Nixon
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, Yorkshire, UK
| | - F C Cowdell
- Faculty of Health Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - S Ersser
- School of Healthcare, University of Leeds, Leeds, Yorkshire, UK
| | - C Fernandez
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, Yorkshire, UK
| | - M Goodfield
- Department of Dermatology, Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, UK
| | - C M Green
- Department of Dermatology, Ninewells Hospital, Dundee, Tayside, UK
| | - P Hampton
- Department of Dermatology, Newcastle Hospitals, Newcastle, Tyne and Wear, UK
| | - J T Lear
- Department of Dermatology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - C H Smith
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - S Tubeuf
- Academic Unit of Health Economics, University of Leeds, Leeds, Yorkshire, UK
| | - M Wittmann
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, Yorkshire, UK.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, Yorkshire, UK.,Department of Dermatology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, Yorkshire, UK
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55
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Thaçi D, Augustin M, Westermayer B, Kamps A, Hennig M. Effectiveness of alitretinoin in severe chronic hand eczema: PASSION, a real-world observational study. J DERMATOL TREAT 2016; 27:577-583. [DOI: 10.1080/09546634.2016.1227422] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mauro M, De Giusti V, Bovenzi M, Larese Filon F. Effectiveness of a secondary prevention protocol for occupational contact dermatitis. J Eur Acad Dermatol Venereol 2016; 31:656-663. [DOI: 10.1111/jdv.13947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/18/2016] [Indexed: 01/20/2023]
Affiliation(s)
- M. Mauro
- Clinical Unit of Occupational Medicine; Department of Medical Sciences; University of Trieste; Trieste Italy
| | - V. De Giusti
- Clinical Unit of Occupational Medicine; Department of Medical Sciences; University of Trieste; Trieste Italy
| | - M. Bovenzi
- Clinical Unit of Occupational Medicine; Department of Medical Sciences; University of Trieste; Trieste Italy
| | - F. Larese Filon
- Clinical Unit of Occupational Medicine; Department of Medical Sciences; University of Trieste; Trieste Italy
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Hand Dermatitis: Utilizing Subtype Classification to Direct Intervention. CURRENT TREATMENT OPTIONS IN ALLERGY 2016. [DOI: 10.1007/s40521-016-0090-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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59
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Mavrogiorgou P, Bader A, Stockfleth E, Juckel G. Obsessive-compulsive disorder in dermatology. J Dtsch Dermatol Ges 2016; 13:991-9. [PMID: 26408459 DOI: 10.1111/ddg.12781] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with obsessive-compulsive (OCD) and related disorders - primarily trichotillomania, body dysmorphic disorder, and skin picking disorder - frequently present to dermatologists due to associated hair and skin symptoms. It is therefore crucial that dermatologists be familiar with these disorders. In this review article, we provide an update on clinical features, neurobiology factors, and treatment options for OCD spectrum disorders. Employing PubMed and Cochrane Library databases, a selective literature search was conducted using keywords related to dermatological disorders within the OCD spectrum. OCD and its related disorders share several phenomenological as well as pathophysiological similarities, thus warranting their classification within a separate nosological category of psychiatric disorders. Another similarity of OCD spectrum disorders is the frequent concurrence of hair and skin diseases. Besides symptomatic dermatological treatment, the combination of psychotherapy (behavioral therapy) and psychopharmacotherapy (SSRIs) may be helpful. Although recent insights into OCD have contributed to a better understanding and treatment thereof, more research is required, especially with respect to OCD spectrum disorders, for which large controlled treatment studies are still lacking.
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Affiliation(s)
- Paraskevi Mavrogiorgou
- LWL University Medical Center of the Ruhr University Bochum, Department of Psychiatry, Psychotherapy, and Preventive Medicine, Bochum, Germany
| | - Armin Bader
- Department of Dermatology, Venereology, and Allergology, St. Joseph Hospital, Medical Center of the Ruhr University Bochum, Germany
| | - Eggert Stockfleth
- Department of Dermatology, Venereology, and Allergology, St. Joseph Hospital, Medical Center of the Ruhr University Bochum, Germany
| | - Georg Juckel
- LWL University Medical Center of the Ruhr University Bochum, Department of Psychiatry, Psychotherapy, and Preventive Medicine, Bochum, Germany
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Park JB, Lee SH, Kim KJ, Lee GY, Yang JM, Kim DW, Lee SJ, Lee CH, Park EJ, Kim KH, Eun HC, Chang SE, Moon KC, Kim SH, Kim SJ, Kim BS, Lee JY, Kim HO, Kang H, Lee MG, Kim SC, Ro YS, Ko JY, Park MY, Kim MH, Shin JH, Choi HY, Hong CK, Lee SY, Bak H, Son SW, Lee AY. Clinical Features and Awareness of Hand Eczema in Korea. Ann Dermatol 2016; 28:335-43. [PMID: 27274632 PMCID: PMC4884710 DOI: 10.5021/ad.2016.28.3.335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/11/2015] [Accepted: 08/13/2015] [Indexed: 11/08/2022] Open
Abstract
Background Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. Objective To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. Methods To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. Results The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. Conclusion Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment.
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Affiliation(s)
- Jae Beom Park
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Seung Ho Lee
- Department of Dermatology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Kea Jeung Kim
- Department of Dermatology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ga-Young Lee
- Department of Dermatology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun-Mo Yang
- Department of Dermatology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do Won Kim
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seok Jong Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Cheol Heon Lee
- Department of Dermatology, Hallym University College of Medicine, Chuncheon, Korea
| | - Eun Joo Park
- Department of Dermatology, Hallym University College of Medicine, Chuncheon, Korea
| | - Kyu Han Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Chul Eun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Chan Moon
- Department of Dermatology, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong Hyun Kim
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Seong Jin Kim
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University Hospital, Busan, Korea
| | - Jun Young Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyung-Ok Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hoon Kang
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Geol Lee
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
| | - Soo-Chan Kim
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Mi Youn Park
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Myung Hwa Kim
- Department of Dermatology, Dankook University Medical College, Cheonan, Korea
| | - Jeong Hyun Shin
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Hae Young Choi
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Chang Kwun Hong
- Department of Dermatology, Chung-Ang University School of Medicine, Seoul, Korea
| | - Sung Yul Lee
- Department of Dermatology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hana Bak
- Department of Dermatology, Hana Clininc, Seoul, Korea
| | - Sang Wook Son
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Ai Young Lee
- Department of Dermatology, Dongguk University Ilsan Hospital, Goyang, Korea
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Kwon HI, Kim JE, Ko JY, Ro YS. Efficacy and Safety of Alitretinoin for Chronic Hand Eczema in Korean Patients. Ann Dermatol 2016; 28:364-70. [PMID: 27274636 PMCID: PMC4884714 DOI: 10.5021/ad.2016.28.3.364] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/04/2016] [Accepted: 02/15/2016] [Indexed: 11/28/2022] Open
Abstract
Background Chronic hand eczema (CHE) tends to be refractory to conventional therapy. Previous clinical trials have found that a 24-week treatment course of oral alitretinoin is effective and well tolerated for CHE treatment. Objective The aim of this study was to investigate the efficacy and safety of oral alitretinoin in Korean CHE patients. Methods A total of 27 patients with moderate to severe CHE took 30 mg of alitretinoin daily for 12 weeks. The primary efficacy parameter was the physician's global assessment (PGA). The response was defined as a patient being "clear" or "almost clear" of disease. The secondary efficacy parameters were the modified total lesion symptom score (mTLSS) and the patients' global assessment (PaGA). All adverse events and laboratory abnormalities were recorded during the treatment period. Results Alitretinoin led to CHE symptom improvement in 44.4% of patients. The PGA, mTLSS, and PaGA scores correlated well with each other. Reported adverse events were typical retinoid class effects and headache was the most common. Conclusion Taking 30 mg of oral alitretinoin daily for 12 weeks was found to be effective in treating Korean patients with CHE, compared with the 24 week-treatment shown in previous studies.
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Affiliation(s)
- Hyoung Il Kwon
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Eun Kim
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
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Hauber AB, Mohamed AF, Gonzalez JM, Otteson Fairchild A, Zelt SC, Graff O. Benefit-risk tradeoff preferences for chronic hand eczema treatments. J DERMATOL TREAT 2016; 28:40-46. [PMID: 27160959 DOI: 10.1080/09546634.2016.1177161] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hand eczema affects approximately 16% of the US population. The long-term prognosis is poor, and 5-7% experience severe chronic hand eczema (sCHE) that interferes with daily activities. Treatments for CHE may be ineffective or associated with adverse events (AEs) that may dissuade patients from pursuing or continuing treatment. For quantification of patient experiences and benefit-risk preferences for outcomes associated with CHE treatments, a web-based discrete choice experiment survey was administered to patients in the United States with a self-reported physician diagnosis of CHE and severe symptoms not resolved with topical agents. Respondents answered a series of treatment choice questions, each requiring evaluation of a pair of hypothetical profiles of medications for sCHE defined by efficacy and risk of several AEs. Improvement in CHE clearing of 25-50% was rated from 1.5 to 3.1 times as important as eliminating a 5% risk of permanent bone problems. The mean maximum acceptable risk of permanent vision problems in exchange for an improvement in CHE clearing of 25-50% ranged from 3.4% to 4.8%. This study demonstrated that patients with CHE rated efficacy improvements associated with treatment of sCHE as more important than eliminating the risks of specific AEs.
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Affiliation(s)
- A Brett Hauber
- a RTI Health Solutions , Research Triangle Park , NC , USA
| | | | | | | | - Susan C Zelt
- b Steifel, a GSK Company , Research Triangle Park , NC , USA
| | - Ole Graff
- b Steifel, a GSK Company , Research Triangle Park , NC , USA
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63
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Politiek K, Christoffers WA, Coenraads PJ, Schuttelaar MLA. Alitretinoin and acitretin in severe chronic hand eczema; results from a retrospective daily practice study. Dermatol Ther 2016; 29:364-371. [DOI: 10.1111/dth.12362] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Klaziena Politiek
- Department of Dermatology; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
| | - Wietske Andrea Christoffers
- Department of Dermatology; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
| | - Pieter-Jan Coenraads
- Department of Dermatology; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
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Zinatulina GM, Fayzullina EV, Fazyilov VH, Vasilkin DA. Particular features of the immune status in microbial eczema and erysipelas patients: a therapeutic method. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-2-87-95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Goal of the study. To study particular features of the immune status in microbial eczema and erysipelas patients in the process of a complex immune modulating therapy with Xymedone®. Materials and methods. the study involved 45 microbial eczema patients and 31 patients with a combined form of microbial eczema and erysipelas (the study group) and healthy subjects (60 and 50 subjects). All of the subjects underwent immunology examinations of their cell and humoral immunity prior to and after the pathogenetic treatment with Xymedone®. The traditional therapy of a combined course of microbial eczema and erysipelas comprised the following basic treatment: third-generation cephalosporins (ceftriaxone): 1.0 g a day for 10 days; second-generation antihistamine drugs (peroral loratadine 10 mg once a day for 10 days) and ascorbic acid 0.5 g a day for 14 days. topical treatment comprised antiseptic agents (furacilin solution 1:1000) at the acute stage, emulsions and creams (depending on the disease stage): topical mometasone furoate 0.1% twice a day for 14 days. The patients receiving Xymedone were treated in the dose of 0.25 g, one pill tree times a day for 14 days. The patients underwent an immunology study using the Sysmex Corporation XT2000 automated analyzer at the CityLab laboratory centers in the city of Kazan. Key findings. Prior to the pathogenic therapy, a high level of CD4 (T helpers) and reduced level of the immunoregulatory index (T helpers to T suppressors ratio) (IRI) was revealed in the microbial eczema patients. Ig А and Ig G concentrations were reliably increased. According to a study of immunology indices, the pathogenic therapy using Xymedone® normalized the number of peripheral blood leucocytes and reliably increased the IRI (p < 0.001) in 45 microbial eczema patients. Prior to the pathogenic therapy, a reduced level of CD3 and CD4 cells was revealed in patients with a combined form of microbial eczema and erysipelas; the levels of CD8 and NK cells (CD16) were also reduced. Ig А, Ig M and IgG concentrations were reliably reduced. According to a study of immunology indices, the pathogenic therapy using Xymedone® increased the concentration of CD3 and CD4 cells. Conclusion. Xymedone®, an immune modulating drug, administered as a part of a combination therapy of microbial eczema patients and patients with a combined form of microbial eczema and erysipelas is a form of supplementary pathogenic I therapy; the treatment improved the cellular and humoral immunity indices.
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65
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Alden K, Chowdhury MMU, Williams PE, Kalavala M. Protocol for investigation of possible soya allergy in patients being considered for treatment with isotretinoin or alitretinoin. Clin Exp Dermatol 2016; 41:326-7. [PMID: 26452340 DOI: 10.1111/ced.12762] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2015] [Indexed: 11/28/2022]
Affiliation(s)
- K Alden
- Department of Dermatology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK.
| | - M M U Chowdhury
- Department of Dermatology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - P E Williams
- Department of Immunology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
| | - M Kalavala
- Department of Dermatology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
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66
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Manage hand dermatitis with preventative measures and a stepwise approach to escalating therapy. DRUGS & THERAPY PERSPECTIVES 2015. [DOI: 10.1007/s40267-015-0247-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mavrogiorgou P, Bader A, Stockfleth E, Juckel G. [Obsessive-compulsive disorder in dermatology]. J Dtsch Dermatol Ges 2015; 13:991-1000. [PMID: 26408458 DOI: 10.1111/ddg.20_12781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Paraskevi Mavrogiorgou
- LWL-Universitätsklinikum der Ruhr-Universität Bochum, Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, Bochum
| | - Armin Bader
- Klinik für Dermatologie, Venerologie und Allergologie, St. Joseph-Hospital, Klinikum der Ruhr-Universität Bochum
| | - Eggert Stockfleth
- Klinik für Dermatologie, Venerologie und Allergologie, St. Joseph-Hospital, Klinikum der Ruhr-Universität Bochum
| | - Georg Juckel
- LWL-Universitätsklinikum der Ruhr-Universität Bochum, Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, Bochum
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69
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Antonov D, Schliemann S, Elsner P. Hand dermatitis: a review of clinical features, prevention and treatment. Am J Clin Dermatol 2015; 16:257-270. [PMID: 25920436 DOI: 10.1007/s40257-015-0130-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Hand dermatitis is a socially significant health problem. This review provides a discussion on the clinical features and patterns as well as the differential diagnosis of hand dermatitis, because these are essential for proper diagnosis in clinical practice. The morphology, however, is poorly related to the etiology in chronic cases. In all cases of chronic hand dermatitis, a full diagnostic examination should be undertaken and the etiology should be clarified and addressed in the treatment concept, instead of just moving directly from a morphological diagnosis to therapy. Preventive measures should be included in the treatment concept according to etiology. A stepwise approach for escalating therapy is advised, including basic topical therapy, topical corticosteroids, calcineurin inhibitors, as well as phototherapy and systemic therapy with corticosteroids, alitretinoin, cyclosporine, methotrexate, azathioprine, and others.
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70
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de León FJ, Berbegal L, Silvestre JF. Management of Chronic Hand Eczema. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:533-44. [PMID: 26005193 DOI: 10.1016/j.ad.2015.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/16/2015] [Accepted: 04/15/2015] [Indexed: 11/17/2022] Open
Abstract
Management of hand eczema is complex because of the broad range of different pathogeneses, courses, and prognoses. Furthermore, the efficacy of most available treatments is not well established and the more severe forms can have a major impact on the patient's quality of life. Patient education, preventive measures, and the use of emollients are the mainstays in the management of hand eczema. High-potency topical corticosteroids are the treatment of choice, with calcineurin inhibitors used for maintenance. Phototherapy or systemic treatments are indicated in patients who do not respond to topical treatments. Switching from topical treatments should not be delayed to avoid sensitizations, time off work, and a negative impact on quality of life. Alitretinoin is the only oral treatment approved for use in chronic hand eczema.
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Affiliation(s)
- F J de León
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España.
| | - L Berbegal
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - J F Silvestre
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
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71
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Morris M, Schifano L, Fong R, Graff O. Safety of alitretinoin for severe refractory chronic hand eczema: Clinical studies and postmarketing surveillance. J DERMATOL TREAT 2015; 27:54-8. [DOI: 10.3109/09546634.2015.1034080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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72
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Ahmed A, Shah R, Papadopoulos L, Bewley A. An ethnographic study into the psychological impact and adaptive mechanisms of living with hand eczema. Clin Exp Dermatol 2015; 40:495-501. [DOI: 10.1111/ced.12619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2014] [Indexed: 01/30/2023]
Affiliation(s)
- A. Ahmed
- Department of Dermatology; Royal Free Hospital; London UK
| | - R. Shah
- Department of Dermatology; Royal London Hospital; Whitechapel London UK
| | - L. Papadopoulos
- Department of Psychology; London Guildhall University; London UK
| | - A. Bewley
- Department of Dermatology; Royal London Hospital; Whitechapel London UK
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Lukács J, Schliemann S, Elsner P. Association between smoking and hand dermatitis - a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2015; 29:1280-4. [DOI: 10.1111/jdv.12971] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 12/16/2014] [Indexed: 01/27/2023]
Affiliation(s)
- J. Lukács
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - S. Schliemann
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - P. Elsner
- Department of Dermatology; University Hospital Jena; Jena Germany
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Scalone L, Cortesi P, Mantovani L, Belisari A, Ayala F, Fortina A, Bonamonte D, Borroni G, Cannavò S, Guarneri F, Cristaudo A, De Pità O, Gallo R, Girolomoni G, Gola M, Lisi P, Pigatto P, Satta R, Giannetti A. Clinical epidemiology of hand eczema in patients accessing dermatological reference centres: results from Italy. Br J Dermatol 2014; 172:187-95. [DOI: 10.1111/bjd.13220] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 11/27/2022]
Affiliation(s)
- L. Scalone
- Research Centre on Public Health (CESP); University of Milan-Bicocca; Villa Serena Via Pergolesi 33 I-20052 Monza Italy
- CHARTA Foundation; Milan Italy
| | - P.A. Cortesi
- Research Centre on Public Health (CESP); University of Milan-Bicocca; Villa Serena Via Pergolesi 33 I-20052 Monza Italy
- CHARTA Foundation; Milan Italy
| | - L.G. Mantovani
- CHARTA Foundation; Milan Italy
- Faculty of Pharmacy; University of Naples Federico II; Naples Italy
| | | | - F. Ayala
- Department of Dermatology; University of Naples Federico II; Naples Italy
| | - A.B. Fortina
- Pediatric Dermatology Unit; Department of Medicine; University of Padova; Padova Italy
| | - D. Bonamonte
- Department of Biomedical Science and Human Oncology; Unit of Dermatology; University of Bari ‘Aldo Moro’; Bari Italy
| | - G. Borroni
- Clinical-Surgical, Diagnostic and Pediatric Science; Dermatology Unit; University of Pavia; Fondazione IRCCS Policlinico San Matteo; Pavia Italy
| | - S.P. Cannavò
- Department of Clinical and Experimental Medicine-Unit of Dermatology; University of Messina; Messina Italy
| | - F. Guarneri
- Department of Clinical and Experimental Medicine-Unit of Dermatology; University of Messina; Messina Italy
| | - A. Cristaudo
- Department of Allergological and Occupational Dermatology; San Gallicano Dermatologic Institute, IRCCS; Rome Italy
| | - O. De Pità
- Laboratory of Immunology; Istituto Dermopatico dell'Immacolata (IDI)-IRCCS; Rome Italy
| | - R. Gallo
- Section of Dermatology; DISSAL - Department of Health Sciences; University of Genoa; Genoa Italy
| | - G. Girolomoni
- Department of Medicine; Section of Dermatology and Venereology; University of Verona; Verona Italy
| | - M. Gola
- Allergological and Occupational Dermatology Unit; Department of Critical Care Medicine and Surgery; University of Florence; Florence Italy
| | - P. Lisi
- Department of Medical and Surgical Specialities and Public Health; Section of Clinical, Allergological and Venereological Dermatology; University of Perugia; Perugia Italy
| | - P.D. Pigatto
- Department of Biomedical Science for Health IRCCS Galeazzi Hospital; University of Milan; Milan Italy
| | - R. Satta
- Institute of Dermatology; University of Sassari; Sassari Italy
| | - A. Giannetti
- Division of Dermatology; University of Modena and Reggio Emilia; Modena Italy
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75
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Schindler M, Drozdenko G, Kühl AA, Worm M. Immunomodulation in patients with chronic hand eczema treated with oral alitretinoin. Int Arch Allergy Immunol 2014; 165:18-26. [PMID: 25277487 DOI: 10.1159/000365659] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 06/27/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Oral alitretinoin (9-cis-retinoic acid; 9-cis-RA) has shown clinical efficacy in patients with chronic hand eczema (CHE). Herein, we investigated the impact of oral 9-cis-RA on the local and systemic immune response in patients with CHE. METHODS Twenty patients with CHE were treated with oral alitretinoin (10 or 30 mg/day) for at least 24 weeks. Blood samples were taken for flow cytometry, and serum samples were assessed by ELISA to determine immunoglobulin (Ig) levels. Skin biopsies from lesional skin were evaluated immunohistochemically. RESULTS Upon 9-cis-RA treatment, improvement of the CHE was observed in all patients. A significant decrease in plasmablasts in the peripheral blood and a significant reduction of serum IgE levels were determined. Furthermore, we detected a significant reduction of CD4+ cells and regulatory T cells in the peripheral blood upon treatment. By contrast, these cell subsets were significantly increased in the affected skin. Cytokine analysis of activated CD154-positive T cells showed a reduction of interleukin (IL)-17 but not of IL-4 or IFN-γ production. CONCLUSIONS Overall, our data indicate a disease-modifying effect of 9-cis-RA, including a systemic decrease in IL-17-positive cells, but decreased serum IgE and CD23 expression. The increased frequency of FoxP3-positive cells in the skin upon treatment may suggest a mechanism by which hand eczema is therapeutically targeted by 9-cis-RA, but this will need to be proven in the future studies.
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Affiliation(s)
- Mandana Schindler
- Allergy Center Charité, Department of Dermatology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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76
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Tan J, Maari C, Nigen S, Bolduc C, Bissonnette R. Open-label exploratory study of acitretin for the treatment of severe chronic hand dermatitis. J DERMATOL TREAT 2014; 26:373-5. [DOI: 10.3109/09546634.2014.952608] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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77
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Lahfa M. [Management of chronic hand eczema]. Ann Dermatol Venereol 2014; 141 Suppl 1:S143-50. [PMID: 24953623 DOI: 10.1016/s0151-9638(14)70151-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The management of hand eczema, more readily called chronic hand dermatitis, is complex. This heaviness is related not only to the disease itself by its different clinical forms but also the multiplicity and diversity of etiological factors, triggering / maintaining or aggravating factors. The repeated therapeutic failures are ransom of incorrect information about the disease and its environment, a lack of clarity in the prescription and duration of treatment in general too short. The reference treatment is high potency topical steroids with or without occlusion for 4-8 weeks followed by alitretinoin 30 mg / day for at least 3-6 months with a monthly lipid and liver monitoring and mandatory monthly pregnancy test in women of childbearing. Associated measures and patient education are the cornerstones of successful treatment. Other alternative treatments such as phototherapy, methotrexate, cyclosporin, mycophenolate mofetil etc. can be considered in case of resistance or for clearing followed by topical treatments.
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Affiliation(s)
- M Lahfa
- Service de dermatologie, pôle Spécialités Médicales, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France.
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Bernier C, Gélot P. [Skin tests in chronic hand dermatitis]. Ann Dermatol Venereol 2014; 141 Suppl 1:S117-26. [PMID: 24953621 DOI: 10.1016/s0151-9638(14)70149-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Chronic hand dermatitis is often multifactorial but allergic causes are frequent and can complicate atopic dermatitis or irritant dermatitis. The management of patients affected by hand dermatitis includes detailed interrogation and a complete examination of the skin. Allergologic tests must be systematically realized if examination is suggestive of contact dermatitis or protein contact dermatitis, if an occupational origin is suspected but also in all patients in which treatment is ineffective. Skin tests include patch tests with the European standard series, specialized or additional series if necessary. Skin tests may also include personal items used by patients on a daily basis. If protein contact dermatitis is suspected skin tests include prick tests. Only complete and definitive eviction of allergens can allow a complete and definitive cure of chronic hand dermatitis.
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Affiliation(s)
- C Bernier
- Service de dermatologie, CHU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
| | - P Gélot
- Service de dermatologie, CHU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
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Abstract
Psychopathology in patients with DCM is as complex as its clinical forms where the factors are numerous and often intricate. It combines psychophysiological, psychopathological factors, behavioral disorders which can be the cause or the consequence of DCM but also the negative impact on quality of life and the simplest daily activities. DCM affects the quality of life of every patient, regardless of the severity. Women are more affected by the DCM that man older age, male sex, atopy and the existence of a contact sensitization are independent risk factors of severity. Depression may affect up to 10 % of patients, should involve greater attention from dermatologists and general practitioners. Health authorities and all health actors should be aware of interactions between secondary cognitive troubles or inherent to DCM and efforts required in terms of preventive measures. Thus, the presence of psychiatric comorbidity is more common in patients with chronic dermatoses. Today it is considered that the emotional environment, built by the mother - child relationship must be optimal, otherwise the mental stability of body image may be compromised. Diminished self-esteem, affects less well managed and somatic expression of emotional content. Recently, a surprising study showed that most patients with refractory occupational dermatitis were not able to recognize the warning sign of flare or the role of psychological factors in the formation and maintenance of the dermatose. In fact, they rejected their personal responsibility in the occurrence of the new flare. To address this public health problem, health authorities, trainers and caregivers should be aware of the cognitive impact of DCM in these patients and interactions with current means of prevention. The role of obsessive-compulsive washing as part of an anxiety disorder or personality disorder is most likely a contributing or maintaining factor systematically underestimated in the pathogenesis of DCM and in the therapeutic management.
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Affiliation(s)
- M Lahfa
- Service de dermatologie, pôle spécialités médicales, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France.
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Ofenloch RF, Weisshaar E, Dumke AK, Molin S, Diepgen TL, Apfelbacher C. The Quality of Life in Hand Eczema Questionnaire (QOLHEQ): validation of the German version of a new disease-specific measure of quality of life for patients with hand eczema. Br J Dermatol 2014; 171:304-12. [PMID: 24397866 DOI: 10.1111/bjd.12819] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is widely used as a patient-reported outcome to evaluate clinical trials. In routine care it can also be used to improve treatment strategies or to enhance patients' self-awareness and empowerment. Therefore a disease-specific instrument is needed that assesses in detail all the impairments caused by the disease of interest. For patients with hand eczema (HE) such an instrument was developed by an international expert group, but its measurement properties are unknown. OBJECTIVES To validate the German version of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ), which covers the domains of (i) symptoms, (ii) emotions, (iii) functioning and (iv) treatment and prevention. METHODS The QOLHEQ was assessed up to three times in 316 patients with HE to test reliability and sensitivity to change. To test construct validity we also assessed several reference measures. The scale structure was analysed using the Rasch model for each subscale and a structural equation model was used to test the multi domain structure of the QOLHEQ. RESULTS After minor adaptions of the scoring structure, all four subscales of the QOLHEQ did not significantly misfit the Rasch model (α > 0·05). The fit indices of the structural equation model showed a good fit of the multi domain construct with four subscales assessing HRQOL. Nearly all a priori-defined hypotheses relating to construct validity could be confirmed. The QOLHEQ showed a sensitivity to change that was superior compared with all reference measures. CONCLUSIONS The QOLHEQ is ready to be used in its German version as a sensitive outcome measure in clinical trials and for routine monitoring. The treatment-relevant subscales enable its use to enhance patients' self-awareness and to monitor treatment decisions.
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Affiliation(s)
- R F Ofenloch
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Heidelberg, Germany
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81
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Abstract
Hand eczema is often a chronic, multifactorial disease. It is usually related to occupational or routine household activities. Exact etiology of the disease is difficult to determine. It may become severe enough and disabling to many of patients in course of time. An estimated 2-10% of population is likely to develop hand eczema at some point of time during life. It appears to be the most common occupational skin disease, comprising 9-35% of all occupational diseases and up to 80% or more of all occupational contact dermatitis. So, it becomes important to find the exact etiology and classification of the disease and to use the appropriate preventive and treatment measures. Despite its importance in the dermatological practice, very few Indian studies have been done till date to investigate the epidemiological trends, etiology, and treatment options for hand eczema. In this review, we tried to find the etiology, epidemiology, and available treatment modalities for chronic hand eczema patients.
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Affiliation(s)
| | | | - Rahul Gupta
- Department of Dermatology, SMS Medical College, Jaipur, India
| | - Puneet Agarwal
- Department of Dermatology, Mahatma Gandhi Institute of Medical Sciences, Jaipur, India
| | - Sheetal Napalia
- Department of Dermatology, Mahatma Gandhi Institute of Medical Sciences, Jaipur, India
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Gelot P, Avenel-Audran M, Balica S, Bensefa L, Crépy MN, Debons M, Ammari H, Milpied B, Raison N, Vigan M, Weibel N, Stalder JF, Bernier C. Éducation thérapeutique du patient dans l’eczéma chronique des mains. Ann Dermatol Venereol 2014; 141 Suppl 1:S127-42. [DOI: 10.1016/s0151-9638(14)70150-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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84
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Corti MA, Stirnimann R, Borradori L, Simon D. Effects of Systematic Patient Education in Skin Care and Protection in a Hand Eczema Clinic. Dermatology 2014; 228:220-4. [DOI: 10.1159/000357523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 11/21/2013] [Indexed: 11/19/2022] Open
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Mollerup A, Veien NK, Johansen JD. Effectiveness of the Healthy Skin Clinic - a randomized clinical trial of nurse-led patient counselling in hand eczema. Contact Dermatitis 2014; 71:202-14. [DOI: 10.1111/cod.12243] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 03/06/2014] [Accepted: 03/11/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Annette Mollerup
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; Niels Andersens Vej 65 2900 Hellerup Denmark
| | - Niels K. Veien
- The Dermatology Clinic; Fyrkildevej 7 9220 Aalborg Øst Denmark
| | - Jeanne D. Johansen
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; Niels Andersens Vej 65 2900 Hellerup Denmark
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86
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Bensefa-Colas L, Choudat D. Main et maladies professionnelles. Presse Med 2013; 42:1627-31. [DOI: 10.1016/j.lpm.2012.09.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 09/13/2012] [Accepted: 09/27/2012] [Indexed: 10/26/2022] Open
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87
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Fisker MH, Agner T, Lindschou J, Bonde JP, Ibler KS, Gluud C, Winkel P, Ebbehøj NE. Protocol for a randomised trial on the effect of group education on skin-protective behaviour versus treatment as usual among individuals with newly notified occupational hand eczema - the Prevention of Hand Eczema (PREVEX) Trial. BMC DERMATOLOGY 2013; 13:16. [PMID: 24245553 PMCID: PMC4225615 DOI: 10.1186/1471-5945-13-16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 11/13/2013] [Indexed: 11/29/2022]
Abstract
Background The incidence of occupational hand eczema is approximately 0.32 per 1,000 person years. The burden of the disease is high, as almost 60% has eczema-related sick leave during the first year after notification, and 15% are excluded from the workforce 12 years after disease onset. New treatments and prevention strategies are needed. Methods/Design Trial design: The PREVEX trial is a randomised, parallel-group, superiority trial. Participants: All individuals from the Capital Region of Denmark and Region Zealand with a suspected occupational skin disorder notified to the National Board of Industrial Injuries between June 2012 and December 2013 are invited to participate in the trial. Inclusion criteria are: self-reported hand eczema and informed consent. Exclusion criteria are: age <18 years or >65 years; permanent exclusion from the workforce; inability to understand the Danish language; any serious medical condition; and lack of written informed consent. We plan to randomise 742 participants. Interventions: The experimental intervention is an educational course in skin-protective behaviour and written information about skin care related to the participants' specific occupation. Also, a telephone hotline is available and a subgroup will be offered a work-place visit. The experimental and the control group have access to usual care and treatment. All participants are contacted every eighth week with questions regarding number of days with sick leave or other absence from work. 12 months after randomisation follow-up is completed. Objective: To assesses the effect of an educational course versus treatment as usual in participants with newly notified occupational hand eczema. Randomisation: Participants are centrally randomised according to a computer-generated allocation sequence with a varying block size concealed to investigators. Blinding: It is not possible to blind the participants and investigators, however, data obtained from registers, data entry, statistical analyses, and drawing of conclusions will be blinded. Outcomes: The three co-primary outcomes, assessed at 12 months, are: total number of self-reported days with sick leave; health-related quality of life; and subjective assessment of hand eczema severity. Explorative outcomes are: self-reported eczema-related sick leave, absence from work registered by the DREAM-register and by self-report, risk behaviour, knowledge of skin protection and performance management (self-efficacy; and self-evaluated ability to self-care). Discussion The PREVEX trial will be the first individually randomised trial to investigate the benefits and harms of group-based education in patients with newly notified occupational hand eczema. Trial registration ClinicalTrials.gov Identifier: NCT01899287
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Affiliation(s)
- Maja Hvid Fisker
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark.
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88
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Mollerup A, Johansen J, Thing L. Knowledge, attitudes and behaviour in everyday life with chronic hand eczema: a qualitative study. Br J Dermatol 2013; 169:1056-65. [DOI: 10.1111/bjd.12524] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2013] [Indexed: 12/18/2022]
Affiliation(s)
- A. Mollerup
- National Allergy Research Centre; Department of Dermato-Allergology; Copenhagen University Hospital Gentofte; Niels Andersens Vej 65 DK-2900 Hellerup Denmark
| | - J.D. Johansen
- National Allergy Research Centre; Department of Dermato-Allergology; Copenhagen University Hospital Gentofte; Niels Andersens Vej 65 DK-2900 Hellerup Denmark
| | - L.F. Thing
- Department of Nutrition; Exercise and Sports; Faculty of Science; University of Copenhagen; Nørre Allé 51-55 DK-2200 Copenhagen N Denmark
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89
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Carøe TK, Ebbehøj N, Agner T. A survey of exposures related to recognized occupational contact dermatitis in Denmark in 2010. Contact Dermatitis 2013; 70:56-62. [DOI: 10.1111/cod.12134] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 07/03/2013] [Accepted: 07/10/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Tanja Korfitsen Carøe
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen NV Denmark
| | - Niels Ebbehøj
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen NV Denmark
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen NV Denmark
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90
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Cortesi PA, Scalone L, Belisari A, Bonamonte D, Cannavò SP, Cristaudo A, De Pità O, Gallo R, Giannetti A, Gola M, Pigatto PD, Mantovani LG. Cost and quality of life in patients with severe chronic hand eczema refractory to standard therapy with topical potent corticosteroids. Contact Dermatitis 2013; 70:158-68. [PMID: 24102212 DOI: 10.1111/cod.12130] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 06/26/2013] [Accepted: 06/30/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND Little is known about the socio-economic burden of severe chronic hand eczema in patients refractory to treatment with potent corticosteroids. OBJECTIVES To estimate the socio-economic burden of severe chronic hand eczema refractory to potent topical corticosteroids, and to establish an algorithm for the estimation of the health-related quality of life EuroQol five-dimensional (EQ-5D) utility index from the Dermatology Life Quality Index (DLQI) summary score. METHODS A multicentre cost of illness study was conducted, adopting the societal perspective. Adult patients with severe and refractory chronic hand eczema were enrolled. Direct (e.g. drug treatment and travel) and indirect (i.e. loss of productivity) mean costs/patient-month were estimated. Health-related quality of life was assessed with the EQ-5D and DLQI questionnaires. An ordinary least square regression model was used to investigate relationships between health-related quality of life scores. RESULTS One hundred and four valid patients (mean age 44.5 years, 39.4% male) participated. Overall mean costs were €418.3/patient-month: loss of productivity contributed 43.7%, followed by hospitalization (16.1%) and travel (10.3%). Health-related quality of life scores were, on average, 0.50 (EQ-5D utility) and 11.3 (DLQI). Utility and DLQI summary were significantly related to each other. CONCLUSIONS Wellbeing and loss of productivity are the most important consequences in these patients. Appropriate treatment is necessary to improve patient health and productivity, which will contribute to reducing societal costs.
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Affiliation(s)
- Paolo A Cortesi
- Research Centre on Public Health (CESP), University of Milan-Bicocca, 20052, Monza, Italy; CHARTA Foundation, 20122 Milano, Italy
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91
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Gola M, D’Erme AM, Milanesi N, Marmugi L. Effects of Alitretinoin on Quality of Life of Patients Having Chronic Hand Eczema. Dermatitis 2013; 24:166-9. [DOI: 10.1097/der.0b013e3182987773] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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92
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Eficacia y seguridad en terapia con psoralen-UVA (PUVA) tópica en psoriasis palmoplantar. Experiencia en una serie de 48 pacientes. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.ad.2012.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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93
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Effectiveness and safety of psoralen-UVA (PUVA) topical therapy in palmoplantar psoriasis: a report on 48 patients. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:418-25. [PMID: 23680012 DOI: 10.1016/j.adengl.2013.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 12/12/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Palmoplantar psoriasis is an uncommon clinical form of psoriasis. Although localized to the palms and soles, it has a considerable impact on the patient's function and quality of life. OBJECTIVES To study the effectiveness and safety of psoralen-UV-A (PUVA) therapy in palmoplantar psoriasis and investigate predictors of clinical response. MATERIAL AND METHODS We performed a retrospective chart review of all patients with palmoplantar psoriasis treated with topical PUVA therapy at our hospital between 2008 and 2011. Data were collected on effectiveness (using physician global assessment [PGA] scores), safety, and a range of clinical, epidemiological, and treatment-related variables. RESULTS We studied 48 patients (33 women and 15 men) with a mean age of 51 years. Treatment was considered to be effective (PGA score of 0 or 1) in 63% of cases. In addition to PUVA, systemic therapy was required in 47.9% of patients; the drug most often used was acitretin. Adverse effects were reported for 25% of patients during treatment. The most common effect was mild erythema, present in 18% of cases. CONCLUSIONS In our experience, topical PUVA is an appropriate treatment alternative for palmoplantar psoriasis; it offers similar response rates to systemic treatments, but has a better tolerance and safety profile. Associated systemic treatment, with acitretin in most cases, improved the probability of a satisfactory response to PUVA and should be considered in patients who do not respond adequately after 8 to 10 sessions.
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94
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Nakamizo S, Egawa G, Doi H, Natsuaki Y, Miyachi Y, Kabashima K. Topical treatment with basic fibroblast growth factor promotes wound healing and barrier recovery induced by skin abrasion. Skin Pharmacol Physiol 2012; 26:22-9. [PMID: 23108135 DOI: 10.1159/000343208] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 09/05/2012] [Indexed: 01/13/2023]
Abstract
It has been reported that basic fibroblast growth factor (bFGF) promotes the healing of skin ulceration by inducing fibroblast proliferation, yet the role of bFGF on epidermal barrier function, especially from the perspective of scratch-induced skin abrasion, remains unknown. To this end, we initially developed an epidermal abrasion mouse model induced by scratching with a stainless-steel wire brush, and examined the effects of bFGF on the wound healing induced by skin abrasion. This procedure induced a significant elevation of transepidermal water loss (TEWL) in a scratch-count-dependent manner. This elevated TEWL was significantly decreased following topical application of bFGF to the skin. In addition, bFGF increased the expression of Ki67 in keratinocytes following mechanical scratching. These results suggest that bFGF enhances keratinocyte proliferation, which, in turn, repairs the skin barrier disruption and wounds caused by scratching in mice. Consistently, bFGF stimulated proliferation of normal human epidermal keratinocytes (NHEK). Intriguingly, the effect of bFGF and other growth factors on NHEK proliferation was additive. However, high cell density diminished the effect of bFGF on NHEK proliferation. This particular result can be explained by our observation that FGF receptor mRNA expression in NHEK was low under conditions of high cell density. Our findings suggest that bFGF stimulates keratinocyte proliferation, especially in a lower cell density environment, to repair skin wound in accord with skin barrier recovery.
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Affiliation(s)
- S Nakamizo
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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95
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Gulliver WP, Baker KA. Effective Treatment of Chronic Hand Dermatitis with 36 Continuous Months of Alitretinoin Administration: Report of Three Cases. J Cutan Med Surg 2012; 16:267-71. [DOI: 10.1177/120347541201600409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Moderate to severe chronic hand dermatitis (CHD) is not well controlled by current medical strategies; however, recent studies have shown significant improvement in patients treated with up to 6 months of oral alitretinoin (9- cis-retinoic acid). The results of longer-term continuous treatment are lacking. Objective: To evaluate the long-term safety and efficacy of alitretinoin for the treatment of CHD. Methods: The Physician's Global Assessment (PGA) and Modified Total Lesion Symptom Score (MTLSS) were used to assess CHD improvement in three patients treated with alitretinoin (10–30 mg/d). Patients had routine bloodwork and were monitored for adverse events. Results: Significant improvement in MTLSS scores (≈ 76%) was seen at 2 months ( p < .002) and maintained for the 3-year treatment period with occasional dosage adjustments. No significant adverse events developed that necessitated treatment withdrawal. Conclusion: Alitretinoin was well tolerated in the treatment of these three CHD patients who were carefully monitored over this prolonged treatment period.
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Affiliation(s)
- Wayne P. Gulliver
- Discipline of Medicine, Faculty of Medicine, Memorial University of Newfoundland, and NewLab Life Sciences, Incorporated, St. John's, NL
| | - Kenneth A. Baker
- Discipline of Medicine, Faculty of Medicine, Memorial University of Newfoundland, and NewLab Life Sciences, Incorporated, St. John's, NL
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Lynde C, Cambazard F, Ruzicka T, Sebastian M, Brown TC, Maares J. Extended treatment with oral alitretinoin for patients with chronic hand eczema not fully responding to initial treatment. Clin Exp Dermatol 2012; 37:712-7. [DOI: 10.1111/j.1365-2230.2012.04396.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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97
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Mollerup A, Veien NK, Johansen JD. Chronic hand eczema--self-management and prognosis: a study protocol for a randomised clinical trial. BMC DERMATOLOGY 2012; 12:6. [PMID: 22691871 PMCID: PMC3492110 DOI: 10.1186/1471-5945-12-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 05/14/2012] [Indexed: 02/08/2023]
Abstract
Background Hand eczema has a one-year prevalence of approximately 10 % in the general Danish population. Often the disease becomes chronic with numerous implications for the individual’s daily life, occupation and quality of life. However, no guidelines of self-management recommendations beyond the acute stage are given. Self-management of the disease is pivotal and involves self-monitoring of the condition, medication adherence, and preventive behaviour. Interventions best to support the individual in this ongoing process need to be developed. Methods/design This paper describes the design of a randomised clinical trial to test a newly developed intervention of individual counselling versus conventional information. 300 patients consecutively referred to dermatologic treatment at two different settings are individually randomised to either the intervention programme, named ‘The Healthy Skin Clinic’ or to the control group. Block-wise randomisation according to setting and gender is carried out. The intervention offers a tool for self-monitoring; basic and specific individual counselling; the possibility of asynchronous communication with the intervention team; and an electronic patient dialogue forum. Primary outcome variable is objective assessment of the hand eczema severity performed at baseline prior to randomisation, and repeated at six months follow-up. Secondary outcome variables are dermatology related life quality and perceived global burden of disease. Discussion The trial aims at evaluating a newly developed guidance programme which is expected to support self-management of patients referred to dermatology treatment due to chronic hand eczema. The design of the protocol is pragmatic with blinding of neither participants nor the investigator. Thus, in the interpretation of the results, the investigator takes into account effects that may be attributed to actors of the interventions rather than the intervention per se as well of potential observer bias. Inclusion criterions are wide in order to increase transferability of the results. Trial registration The trial is registered in ClinicalTrials.Gov with registration number NCT01482663.
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Affiliation(s)
- Annette Mollerup
- National Allergy Research Centre, Copenhagen University Hospital Gentofte, Gentofte, Denmark.
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Basra MK, Chowdhury MM, Smith EV, Freemantle N, Piguet V. A Review of the Use of the Dermatology Life Quality Index as a Criterion in Clinical Guidelines and Health Technology Assessments in Psoriasis and Chronic Hand Eczema. Dermatol Clin 2012; 30:237-44, viii. [DOI: 10.1016/j.det.2011.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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99
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van Gils RF, Boot CRL, Knol DL, Rustemeyer T, van Mechelen W, van der Valk PGM, Anema JR. The effectiveness of integrated care for patients with hand eczema: results of a randomized, controlled trial. Contact Dermatitis 2012; 66:197-204. [DOI: 10.1111/j.1600-0536.2011.02024.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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100
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van Gils RF, Groenewoud K, Boot CRL, Rustemeyer T, van Mechelen W, van der Valk PGM, Anema JR. Process evaluation of an integrated, multidisciplinary intervention programme for hand eczema. Contact Dermatitis 2012; 66:254-63. [DOI: 10.1111/j.1600-0536.2011.02031.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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