Protocol for the development of a core domain set for hand eczema trials

Development of a core domain set for nailfold capillaroscopy reporting

BACKGROUND

The peripheral microangiopathy may be well evaluated and studied by nailfold capillaroscopy (NFC) which is a safe and non-invasive technique. NFC has been reported to have both diagnostic and prognostic values in patients presenting with Raynaud's phenomenon.

OBJECTIVE

The overarching objective of this work was to make a consensus on what domains should be included in a capillaroscopy report and that it can be used in daily clinical practice and clinical research in the area of rheumatology.

METHODS

A Delphi questionnaire was developed regarding capillaroscopy report from a literature review and expert consensus. The first Delphi round included 14 core areas, its 18 domains with 50 subdomains, derived from a systematic literature review. The level of evidence was determined for each core set using the Oxford Centre for Evidence-based Medicine (CEBM) system. Nine response categories have been set per each item ranging between 1 and 9. Round 2, aimed to reach preliminary consensus "in" or "out" for domains. It included all items that were rated "critical" by at least 80% of the participants as well as any new domains proposed in round 1.

RESULTS

The participants to the first, and second round were 11 experts. Fourteen domains were discussed in the two rounds. At the end of the survey, the final report template of NFC in rheumatology reached a consensus.

CONCLUSION

A nailfold capillaroscopy report template has been developed by this study, based on outcomes of a Delphi process, by international participants panel. All domains met the 80% voting threshold set in this work. The reporting template can be used for both clinical research as well as day to day practice to provide guidance and standardize the NFC reporting.

Evaluation of the secondary and tertiary prevention strategies against occupational contact dermatitis in Germany: a systematic review

BACKGROUND

In Germany, a stepwise multidisciplinary approach has been established to prevent occupational skin diseases (OSDs), primarily occupational contact dermatitis.

OBJECTIVES

To perform a systematic evaluation of the short- and long-term effects of the German secondary and tertiary individual prevention programmes (SIP and TIP) for OSD. Primary outcomes were continuation of employment, severity of hand dermatitis, and quality of life (QoL).

METHOD

The PubMed and Embase databases were searched for studies reporting the effects of the SIP and TIP.

RESULTS

A total of 19 studies encompassing 5527 patients with OSD were included: 11 studies evaluated the SIP and 8 studies evaluated the TIP. Following the SIP, approximately 70-90% and 60-70% of patients remained in their occupation after 1 and 5 years, respectively. At 3 years after the TIP, 82.7% of patients remained in their occupation and exhibited a significant decrease in hand dermatitis severity, as well as an increase in QoL.

LIMITATIONS

Most of these studies were uncontrolled and the interventions, outcomes, and measurement instruments used were heterogeneous.

CONCLUSIONS

The SIP and TIP lead to decreased disease severity, improved QoL and enabled most patients to continue working in their chosen professions. Implementing a similar multidisciplinary approach across Europe may be beneficial. This article is protected by copyright. All rights reserved.

Hand eczema among healthcare workers in Guangzhou City: a cross-sectional study

Background

Healthcare workers are at high risk of developing hand eczema. This study aimed to investigate the association between occupational hygiene and self-reported hand eczema among nurses and doctors in Guangzhou.

Methods

A cross-sectional study using a self-administrated questionnaire sent to 740 health care workers in two tertiary hospitals between 1^st April and 1^st July 2019 was conducted.

Results

In total, 521 healthcare workers responded (70.4%). The prevalence of self-reported hand eczema was 9.6% [95% confidence interval (CI): 7.1-12.1%], with 10.8% in nurses and 6.9% in doctors. According to multivariable logistic regression analysis, the prevalence was higher in those who were excessively exposed to hair dye (OR: 3.871, 95% CI: 1.106-13.549) and those having a history of food allergy were at 3.013 (95% CI: 1.314-6.907) times greater risk of having hand eczema than those who did not. The odds of having hand eczema were 4.863 (95% CI: 1.037-22.803) times greater in those who hand washed more than 50 times daily in comparison to those who washed hands less than 10 times per day. The symptoms of hand eczema were mild during the investigation period.

Conclusions

Hand eczema is common among healthcare workers in Guangzhou. The prevention of hand eczema by educational programs is needed for Chinese healthcare workers.