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Quaade AS, Wang X, Sølberg JBK, McCauley BD, Thyssen JP, Becker C, Johansen JD. Inflammatory plasma signature of chronic hand eczema: Associations with aetiological and clinical subtypes. J Eur Acad Dermatol Venereol 2024; 38:1101-1111. [PMID: 38151335 DOI: 10.1111/jdv.19742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/10/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Chronic hand eczema (CHE) is a highly prevalent, heterogeneous, skin disease that encompasses different aetiological and clinical subtypes. Severe CHE without atopic dermatitis has been associated with systemic inflammation; yet it remains unknown if specific CHE subtypes leave distinct, systemic, molecular signatures. OBJECTIVES To characterize the inflammatory plasma signature of different aetiological and clinical CHE subtypes. METHODS We assessed expression levels of 266 inflammatory and cardiovascular disease risk plasma proteins as well as filaggrin gene mutation status in 51 well-characterized CHE patients without concomitant atopic dermatitis and 40 healthy controls. Plasma protein expression was compared between aetiological and clinical CHE subgroups and controls both overall and according to clinical CHE severity. Correlation analyses for biomarkers, clinical and self-reported variables were performed. RESULTS Very severe, chronic allergic contact dermatitis (ACD) on the hands was associated with a mixed Type 1/Type 2 systemic immune activation as compared with controls. Circulating levels of Type 1/Type 2 inflammatory biomarkers correlated positively with clinical disease severity among CHE patients with ACD. No biomarkers were found, that could discriminate between aetiological subtypes, for example, between ACD and irritant contact dermatitis. Hyperkeratotic CHE showed a distinct, non-atopic dermatitis-like, systemic footprint with upregulation of markers associated with Type 1 inflammation and tumour necrosis factor alpha, but not Type 2 inflammation. Increased levels of CCL19 and CXCL9/10 could discriminate hyperkeratotic CHE from both vesicular and chronic fissured CHE, whereas no difference was found between the latter two subtypes. CONCLUSION Profiling of systemic biomarkers showed potential for identifying certain CHE subtypes. Peripheral blood levels of inflammatory biomarkers were associated and correlated with the clinical disease severity of chronic ACD on the hands, underlining that this is a systemic disease. We question whether hyperkeratotic CHE should be classified as eczema.
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Affiliation(s)
- Anna Sophie Quaade
- Department of Dermatology and Allergy, The National Allergy Research Centre, Copenhagen University Hospital, Herlev-Gentofte, Hellerup, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Xing Wang
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Julie B K Sølberg
- Department of Dermatology and Allergy, The National Allergy Research Centre, Copenhagen University Hospital, Herlev-Gentofte, Hellerup, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Benjamin D McCauley
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Jacob P Thyssen
- University of Copenhagen, Copenhagen, Denmark
- The National Allergy Research Centre, Copenhagen University Hospital, Herlev-Gentofte, Hellerup, Denmark
| | - Christine Becker
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Jeanne Duus Johansen
- Department of Dermatology and Allergy, The National Allergy Research Centre, Copenhagen University Hospital, Herlev-Gentofte, Hellerup, Denmark
- University of Copenhagen, Copenhagen, Denmark
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Borg E, Munro D, Thoning H. The management of Chronic Hand Eczema: A retrospective patient record review. Contact Dermatitis 2024; 90:365-371. [PMID: 38164049 DOI: 10.1111/cod.14477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Chronic Hand Eczema (CHE) is a heterogeneous fluctuating inflammatory disease that represents a significant burden. Effective treatment options for moderate to severe CHE are limited. OBJECTIVES To assess how patients with moderate to severe CHE are treated in clinical practice. METHODS A retrospective, physician-led patient record review assessed the demographic, clinical and treatment characteristics of patients aged ≥18 years with CHE across seven countries. Each participating physician was requested to review records for their three most recent patients with moderate to severe CHE treated with a topical or systemic therapy. RESULTS A total of 264 physicians, of whom 88.6% were dermatologists and 70.1% were predominantly or partly hospital-based, reviewed the records of 792 patients. Signs were present on hands only in 56.4% of patients and the mean time on current treatment was 16.7 months. Overall, 62.9% of patients received systemic therapy and almost one-quarter (23.4%) were treated with a biologic; 28.6% of patients were only treated with topical corticosteroids and/or topical calcineurin inhibitors. CONCLUSION In patients with moderate to severe CHE, most received systemic therapy with one-quarter on biologic therapy. However, given that many of these treatments have limited evidence of efficacy in CHE, there is a need for studies specifically in patients with CHE as well as new therapeutic options.
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Ortiz de Frutos FJ, Silvestre JF. Recommendations on the Use of Moisturizing Products Prepared by Spanish Dermatologists Using the Delphi Method. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00266-7. [PMID: 38554751 DOI: 10.1016/j.ad.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/27/2024] [Accepted: 03/13/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Moisturizing products are widely used in conditions affecting skin hydration. However, the lack of scientific evidence leads to discrepancies and great variability in the recommendations used by different health professionals. The aim of this consensus document is to generate recommendations based on the evidence and experience of dermatologists to unify and facilitate the use of moisturizing products in the routine clinical practice. MATERIALS AND METHODS A 49-statement questionnaire on moisturizing products was prepared and, then, arranged in 5 blocks: 1) concept; 2) characteristics, 3) frequency and quantity, 4) product use and areas of application, and 5) special populations. Twenty-two expert dermatologists in the management of patients with eczema answered to the survey using a 2-round Delphi methodology (adding an item on the 2nd round). RESULTS Consensus was reached on 27 statements (54%), most (n=23) via agreement. The highest level of agreement was reached in the blocks on quantity, product use and areas of application (77.8%), followed by the blocks on characteristics (73%) and frequency (62.5%). Regarding the blocks on concept and special populations, the level of consensus on the items proposed was 37.5% and 10%, respectively. Consensus on the use of emollients for xeroderma (71%) was higher vs atopic dermatitis (64%) and inflamed skin (33.3%). CONCLUSIONS Consensus recommendations can help all prescribers and improve the available evidence regarding their use.
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Affiliation(s)
- F J Ortiz de Frutos
- Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España.
| | - J F Silvestre
- Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, España
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Tancredi V, Buononato D, Caccavale S, Di Brizzi EV, Di Caprio R, Argenziano G, Balato A. New Perspectives in the Management of Chronic Hand Eczema: Lessons from Pathogenesis. Int J Mol Sci 2023; 25:362. [PMID: 38203533 PMCID: PMC10778876 DOI: 10.3390/ijms25010362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Chronic hand eczema (CHE) is a common inflammatory skin condition that significantly impacts the quality of life. From work-related disabilities to social embarrassment, pain, and financial costs, the burden on society is substantial. Managing this condition presents challenges such as long-term treatment, poor patient compliance, therapy side effects, and economic feasibility. As a result, significant efforts have been made in this field in recent years. Specifically, the broader understanding of CHE pathogenesis has led to the development of new drugs, both topical and systemic. The aim of this narrative review is to summarize the current available data on hand eczema pathophysiology and explore the resulting developments in drugs for its treatment. A comprehensive search on PubMed and the other main scientific databases was conducted using keywords related to CHE and its pathogenesis. The most relevant pathways targeted by therapies include the JAK-STAT cascade, IL-4, and IL-13 axis, phosphodiesterase 4 enzyme, and chemo-attractant cytokines. In the near future, physicians will have a plethora of therapeutic alternatives. Consequently, they should be well-trained not only in how to use these alternatives but also how to combine these treatments to address the ongoing challenges related to efficacy, tolerability, and safety.
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Affiliation(s)
| | | | | | | | | | | | - Anna Balato
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (D.B.)
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Quaade AS, Alinaghi F, Dietz JBN, Erichsen CY, Johansen JD. Chronic hand eczema: A prevalent disease in the general population associated with reduced quality of life and poor overall health measures. Contact Dermatitis 2023; 89:453-463. [PMID: 37634937 DOI: 10.1111/cod.14407] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The impact of hand eczema (HE) on Health-Related Quality of Life (HRQoL) has only been sparsely studied in a general population setting, and never by use of the disease specific Quality Of Life in Hand eczema Questionnaire (QOLHEQ). OBJECTIVES To examine the HRQoL of unselected individuals with HE using the QOLHEQ. Further, to provide prevalence estimates of severe and chronic HE (CHE), and to contrast overall health related outcomes between individuals with and without HE. METHODS In this nationwide, cross-sectional study a questionnaire covering questions on HE related outcomes, and overall health was sent to a random sample of 100 000 Danish adults via a secure digital mailbox, linked to their unique civil registration numbers. Data on demographic characteristics were retrieved from the civil registration system. Individuals reporting HE, further answered the QOLHEQ and other disease specific questions. RESULTS The response rate was 42.7% (n = 42 691). Total estimates of lifetime, 1-year and point prevalences of HE were 24.4%, 13.3% and 5.8%. Of individuals reporting a 1-year prevalence, 35.1% reported moderate-severe disease and 82.6% CHE. Individuals with HE were more likely to report less good or poor overall health, and sick leave (any reason), compared to those without. In the 2176 (92.5%) with current HE who completed the QOLHEQ, median QOLHEQ scores corresponded to a moderate impairment of the symptoms and treatment and prevention domains and a slight impairment overall and for the emotions and functioning domains. Factors that were strongly associated with moderate to severe HRQoL impairment included severe, chronic and occupational HE as well as female sex. CONCLUSIONS HE is highly prevalent, bears a considerable burden on society and significantly affects the lives of impacted individuals. Our findings indicate a necessity for targeted prevention aimed at high-risk groups, and support and treatment for those most affected.
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Affiliation(s)
- Anna Sophie Quaade
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Farzad Alinaghi
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Jojo Biel-Nielsen Dietz
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Christina Yndal Erichsen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
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Szepietowska M, Dabrowska A, Dziasek S, Lisicki B, Skinderowicz K, Wilczynski B, Krajewski PK, Szepietowski JC. Adolescents' Knowledge and Attitudes Related to Hand Eczema: A Cross-Sectional Study. Clin Cosmet Investig Dermatol 2023; 16:1963-1967. [PMID: 37533496 PMCID: PMC10391528 DOI: 10.2147/ccid.s418352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/30/2023] [Indexed: 08/04/2023]
Abstract
Background Hand eczema (HE) is a common inflammatory skin disease occurring in subjects of any age. Literature data on knowledge of HE in different age-groups are scarce. Purpose To evaluate knowledge and attitudes related to HE among adolescents. Methods A total of 258 high school students were invited to participate in this project. A specially designed questionnaire created on the base of previous studies was used to assess adolescents' knowledge of HE. HE was self-reported answering the validated single question "Have you ever had hand eczema?" Results Data from 243 students (94.2% response rate) were obtained for final analysis. There were 117 (48.1%) females and 126 (51.9%), males with a mean age of 16.0±1.7 years. Sixty-eight students (28%) reported a personal history of HE, and 32.8% declared having knowledge of HE. More females than males (P=0.023) declared that they knew what HE was (39.3% and 26.2%, respectively). Hand cream was used on a regular basis by 49% of adolescents. Females used hand cream more frequently (P<0.001) than males. No difference in declared knowledge of HE was found between subjects with and without a personal history of hand lesions. Students declaring having adequate knowledge of HE used hand cream more commonly (P=0.045). Conclusion Although HE is a common disease in the general population, including adolescents, less than a third of subjects were aware of this entity. Almost half were using hand cream, but interestingly, personal history of HE did not increase the regular application of hand cream.
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Affiliation(s)
- Marta Szepietowska
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Alicja Dabrowska
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Szymon Dziasek
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Lisicki
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Skinderowicz
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Wilczynski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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Quaade AS, Wang X, Sølberg JBK, Ulrich NH, McCauley BD, Thyssen JP, Becker C, Johansen JD. Circulating biomarkers are associated with disease severity of chronic hand eczema and atopic dermatitis. Br J Dermatol 2023; 189:114-124. [PMID: 37052074 DOI: 10.1093/bjd/ljad110] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Although chronic hand eczema (CHE) is a highly prevalent and disabling skin disease, it is currently unknown if CHE is associated with systemic inflammation. OBJECTIVES To characterize the plasma inflammatory signature of CHE. METHODS Using Proximity Extension Assay technology, we assessed 266 inflammatory and cardiovascular disease risk proteins in the plasma of 40 healthy controls, 57 patients with atopic dermatitis (AD) with active lesions, 11 with CHE and a history of AD (CHEPREVIOUS_AD), and 40 with CHE and no history of AD (CHENO_AD). Filaggrin gene mutation status was also assessed. Protein expression was compared between groups and according to disease severity. Correlation analyses for biomarkers, and clinical- and self-reported variables, were performed. RESULTS Very severe CHENO_AD was associated with systemic inflammation when compared with controls. Levels of T helper (Th)2- and Th1-, general inflammation and eosinophil activation markers increased with severity of CHENO_AD, primarily being significantly increased in very severe disease. Significant, positive correlations were found between markers from these pathways and severity of CHENO_AD. Moderate-to-severe but not mild AD displayed systemic inflammation. The Th2 markers C-C motif chemokine (CCL)17 and CCL13 (also known as monocyte chemotactic protein 4) were the top differentially expressed proteins in both very severe CHENO_AD and moderate-to-severe AD, showing a higher fold change and significance in AD. CCL17 and CCL13 levels further correlated positively with disease severity in both CHENO_AD and AD. CONCLUSIONS Systemic Th2-driven inflammation is shared between very severe CHE with no history of AD, and moderate-to-severe AD, suggesting that Th2 cell targeting could be effective in several CHE subtypes.
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Affiliation(s)
- Anna S Quaade
- The National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Xing Wang
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie B K Sølberg
- The National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Nina H Ulrich
- The National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Benjamin D McCauley
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jacob P Thyssen
- The National Allergy Research Centre, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Christine Becker
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeanne D Johansen
- The National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
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Japundžić I, Lugović-Mihić L, Košćec Bjelajac A, Macan J, Novak-Hlebar I, Buljan M, Zovak M, Vidović D, Trkanjec Z, Kuna M. Psychological Stress and Hand Eczema in Physicians and Dentists: A Comparison Based on Surgical Work. Behav Sci (Basel) 2023; 13:bs13050379. [PMID: 37232616 DOI: 10.3390/bs13050379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This research looks at the connection between psychological stress and the prevalence of hand eczema (HE) among physicians and dentists (surgeons, non-surgeons). METHODS This cross-sectional field study involved 185 participants: physicians (surgeons, non-surgeons), dentists (surgeons, non-surgeons) and controls. Hand lesions were examined using the Osnabrueck Hand Eczema Severity Index (OHSI), and participants answered the Nordic Occupational Skin Questionnaire (NOSQ) and Perceived Stress Scale (PSS). Patch tests were performed using commercial contact allergens. RESULTS The estimated prevalence of HE (self-reported) was 43.9% (physicians 44.6%; dentists 43.2%). HE was significantly more reported by surgeons than controls (p < 0.004; V = 0.288). Degrees of perceived stress (PSS) did not differ significantly between the groups, though physicians non-surgeons most exhibited high stress (50%), and physicians surgeons most exhibited low stress (22.5%). High stress was associated with 2.5 higher odds for self-reported HE (p = 0.008). Low stress was greater among physicians/dentists who did not report eczema (41.0% vs. 24.6%); moderate stress was more common among those who reported eczema (72.3% vs. 51.8%; p = 0.038; V = 0.210). CONCLUSIONS Since high stress levels may negatively influence physicians'/dentists' work and quality of life, measures to decrease stress could be introduced into the treatment of healthcare workers who are prone to it.
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Affiliation(s)
- Iva Japundžić
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
| | - Liborija Lugović-Mihić
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Adrijana Košćec Bjelajac
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, 10000 Zagreb, Croatia
| | - Jelena Macan
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, 10000 Zagreb, Croatia
| | - Ina Novak-Hlebar
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
| | - Marija Buljan
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Mario Zovak
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Traumatology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
| | - Dinko Vidović
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Traumatology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
| | - Zlatko Trkanjec
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Neurology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
| | - Matea Kuna
- Department of Dermatovenereology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
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Are There Ethnic Differences in Hand Eczema? A Review. J Clin Med 2023; 12:jcm12062232. [PMID: 36983235 PMCID: PMC10056516 DOI: 10.3390/jcm12062232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/06/2023] [Accepted: 03/12/2023] [Indexed: 03/18/2023] Open
Abstract
Hand eczema is a common disease with economic and social ramifications. This study undertakes a review of certain existing literature to provide insight into contributory factors which may result in the varying prevalence and severity of hand eczema among different ethnic groups, particularly to identify modifiable risk factors, as well as to ascertain knowledge gaps for future research direction. The existing literature suggests that factors including (a) genes, (b) differing skin physiology, (c) cultural practices, (d) dietary habits and associated food preparation, (e) climate, (f) predominant occupations, (g) socioeconomic factors, and (h) dissimilar laws and regulations may account for the disparity in the risk of hand eczema among different ethnicities. Given that endogenous factors cannot be avoided, but certain exogenous aspects can be modified, especially as the environment plays an important role in hand eczema flares, it is helpful from a practical perspective to focus on addressing the modifiable risk factors. These factors pertain to unique cultural practices, customs, and food preparation methods. Healthcare professionals should be well-acquainted with such factors to tailor the treatment approach for patients of different ethnicities accordingly because, with globalization, physicians face increasingly diverse patient populations such that cultural customs no longer remain limited to particular geographic regions.
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Seité S, Le Dantec G, Demessant-Flavigny A, Kerob D. Survey of Hand Issues Encountered by Hairdressers and Hairdresser Related Professionals: From Epidemiological Data to Clinical Observational Survey Results. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2023; 16:111-117. [PMID: 36698444 PMCID: PMC9868141 DOI: 10.2147/ccid.s385681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/07/2023] [Indexed: 01/18/2023]
Abstract
Introduction Hand eczema is frequent among hairdressers. The aim of this open survey was (i) to assess the prevalence and identify causing factors of hand issues encountered by hairdressers and (ii) to assess the benefit of a cosmetic skin care in clinical signs and symptoms through a clinical observational survey. Methods The survey was conducted among 391 hairdressers and hairdresser-related professionals, collecting information on frequency of daily procedures, frequency/type/severity of hand issues, and glove usage. The satisfaction provided by a dermocosmetic containing niacinamide, glycerin, shea butter and thermal spring water was examined in an evaluation visit one month after survey initiation. Results Investigated subjects were mostly hairdressers (73%). In their daily procedures, a majority (≥76%) always or often used shampoos, hair dyes, oxidants, bleachers, straighteners and perms. Overall, a majority (>60%) of subjects always or often had hand irritation due to this use (except for straighteners). Most subjects (≥60%) reported using gloves in their procedures except with shampoos and straighteners. Among hand problems reported at survey initiation, the most intense was skin dryness, followed by redness, irritation, cracks, and fissures. Hand problems induced annoyance in their activities for most subjects (>65%), leading to discontinuation of their professional activities for 28% subjects. The test dermocosmetic was applied for 1 week up to 1 month. At evaluation visit (1 month), the intensity of all hand signs and symptoms was decreased compared to initiation visit. In addition, 58.3% subjects reported return to professional activities instantly at evaluation visit versus 31.3% at initial visit. Most subjects (≥73%) were satisfied or very satisfied with the test cream properties. Conclusion Our survey confirms the impact of hand issues experienced by hairdresser professionals and highlights the need for gloves and for efficient hand care products.
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Affiliation(s)
- Sophie Seité
- Medical Department, La Roche-Posay International, Levallois-Perret, France
| | | | | | - Delphine Kerob
- Medical Department, La Roche-Posay International, Levallois-Perret, France,Correspondence: Delphine Kerob, Cosmétique Active International, La Roche-Posay International, 62 quai Charles Pasqua, Levallois-Perret, 92300, France, Tel +33 6 62 40 22 52, Email
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