Assessment of hand eczema severity by patients using the hand eczema severity index (HECSI)

BACKGROUND

Hand eczema severity index (HECSI) is a widely used tool for assessment of hand eczema (HE) severity. Generally, HECSI has been used by health care providers, and a validation of the HECSI tool when used by patients is lacking.

OBJECTIVES

To evaluate the construct validity and reliability of HECSI as a tool for patients based on comparison to HECSI assessments by physicians.

METHODS

Patients with HE, enrolled from the dermatological outpatient clinic, Bispebjerg Hospital, assessed HE severity with a patient version of HECSI (patient-HECSI). Afterwards, HECSI was assessed by a trained physician (physician-HECSI).

RESULTS

This study found a strong correlation and very good absolute agreement between patient-HECSI and physician-HECSI assessments with a correlation coefficient of 0.756 and intraclass correlation coefficient (ICC) of 0.844. Cronbach's alpha was 0.861 indicating very good internal consistency.

CONCLUSION

With a strong construct validity and reliability, the patient-HECSI may be used by patients as a patient-reported outcome assessing their personal HE severity.

Quality of life, anxiety, depression, social anxiety and avoidance in patients with chronic hand eczema

BACKGROUND

Previous studies have demonstrated that chronic hand eczema (CHE) causes negative effects on psychological status of patients. However, presence of social anxiety and avoidance has not been investigated in CHE patients. In this descriptive and prospective study, we aimed to examine the psychosocial dimensions of CHE in a more detailed manner.

METHODS

70 patients with CHE and 70 controls were participated in the study. The quality of life (QoL) was assessed with the World Health Organization QoL Questionnaire-Short Form (WHOQoL-BREF); anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (HADS); and social anxiety and avoidance were evaluated with the Liebowitz Social Anxiety Scale (LSAS).

RESULTS

The physical and environmental subscale scores of the WHOQoL-BREF were significantly lower (P<0.001, P=0.041); whereas HADS-total (P=0.019), HADSanxiety (P=0.014), LSAS-total (P=0.025), LSAS-anxiety (P=0.037) and LSASavoidance (P=0,029) scores were significantly higher in CHE patients compared to controls. The physical (r=-0.260, p=0.002) and social (r=0.204, p=0.016) domains of the WHOQoL-BREF scale negatively correlated with the severity of eczema, while the psychological (r=-0.363, p=0.002) and environmental (r=-0.456, p<0.001) domains negatively correlated with the extent of eczema. HADS-total (r=0.284, p=0.017) and HADS-depression (r=0.311, p=0.009) also showed positive correlations with the extent of the CHE.

CONCLUSIONS

Considering that impairment in QoL may be associated with psychosocial morbidity, it is important to develop strategies to recognize and treat those psychiatric comorbidities in patients with CHE.

Hand eczema as a risk factor for food allergy among occupational kitchen workers

BACKGROUND

An increasing number of studies in children is highlighting the importance of transdermal routes of exposure to food allergens through damaged skin in the pathogenesis of food allergies. However, data on this in adults are limited. A few case-series studies has documented development of food allergy among kitchen workers with hand eczema after direct contact exposure to foods.

METHODS

To explore the significance of hand eczema as a risk factor for food allergies in adults at the epidemiological level, we performed a cross-sectional web-based questionnaire survey on kitchen workers whose exposures were classed as occupational (cooks and food handlers, n = 1592) or non-occupational (housewives, n = 1915). Logistic regression was used to explore the association between the presence/severity of hand eczema and the risk of food allergy after adjustment for potential confounders.

RESULTS

Current hand eczema and current diagnosed food allergy were more common among occupational kitchen workers (OKW) than among non-occupational kitchen workers (NOKW) (32.3%-vs-29.9% and 9.9%-vs-3.8%, respectively). Current hand eczema was significantly associated with increased risk of current diagnosed food allergy in OKW (adjusted odds ratio 2.4, 95% CI 1.6-3.7). Those with more severe hand eczema were more likely to suffer from allergic symptoms for foods, and diagnosed food allergy.

CONCLUSIONS

This study illustrates a significant public health problem in the adult population, documenting a major impact of hand eczema on the ongoing adult food allergy epidemic.

Romanian Questionnaire to Assess the Prevalence of Occupational Hand Eczema among Healthcare Providers

Occupational skin diseases have an unknown prevalence in Romania, although they are considered the most frequent occupational diseases reported in Western European countries. Self-reported hand eczema among healthcare providers by questionnaire aims to estimate the prevalence of work-related hand eczema and associated risk factors in hospitals and outpatient units in Romania. The aim of this study is to discuss and to validate a questionnaire for surveying work-related skin diseases and exposure among healthcare providers.