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Christensen MO, Yüksel YT, Vittrup I, Nymand LK, Thein D, Nørreslet LB, Toft-Hansen JM, Janstrup AK, Zachariae C, Sommerlund M, Bregnhøj A, Egeberg A, Agner T, Thomsen SF, Thyssen JP. Demographics, characteristics and medical treatment among adults with hand eczema in Denmark. A cross-sectional validation and registry-based study. Contact Dermatitis 2024; 90:350-364. [PMID: 37990822 DOI: 10.1111/cod.14456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND The international classification of diseases, 10th revision (ICD-10) includes several unvalidated diagnostic codes for hand eczema (HE). Knowledge is sparse on HE patient characteristics. OBJECTIVES To validate selected HE ICD-10 codes in the Danish National Patient Registry (DNPR) and describe disease characteristics, lifestyle factors and medication use in adult HE patients. METHODS Nineteen HE ICD-10 codes were selected and validated based on patient charts. Five cohorts were constructed based on the diagnostic code, DL30.8H (HE unspecified), in the DNPR: (i) patients with DL30.8H code (n = 8386), (ii) patients with DL30.8H code, but without atopic dermatitis (AD) (n = 7406), (iii) sex- and age-matched general population (n = 8386) without HE. Two additional cohorts nested in the DNPR included participants from the Danish Skin Cohort, (iv) patients with DL30.8H code but without AD (n = 1340) and (v) general population cohort (n = 9876). RESULTS ICD-10 codes revealed positive predictive values ≥90% except irritant contact dermatitis (unspecified) (79.7%) and hyperkeratotic hand and foot eczema (84.1%). HE patients were most often women, middle-aged or older, of Danish ethnicity, had an atopic medical history and were smokers. Topical corticosteroid prescriptions were almost doubled in HE cohorts compared to general populations. CONCLUSION We validated several HE ICD-10 codes and identified important HE patient characteristics.
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Affiliation(s)
- Maria Oberländer Christensen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Yasemin Topal Yüksel
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ida Vittrup
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lea Krog Nymand
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - David Thein
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Line Brok Nørreslet
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Maarbjerg Toft-Hansen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anne Klose Janstrup
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mette Sommerlund
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Bregnhøj
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Tove Agner
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Pontoppidan Thyssen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Janstrup AK, Nørreslet LB, Toft-Hansen JM, Ofenloch R, Agner T, Yüksel YT. Assessment of hand eczema severity by patients using the hand eczema severity index (HECSI). J Eur Acad Dermatol Venereol 2023; 37:2349-2354. [PMID: 37432043 DOI: 10.1111/jdv.19329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023]
Abstract
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.
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Affiliation(s)
- Anne Klose Janstrup
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Line Brok Nørreslet
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | | | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Tove Agner
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
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Yüksel YT, Edslev SM, Janstrup AK, Goldeman MS, Nørreslet LB, Andersen PS, Agner T. Colonization with Staphylococcus aureus in healthcare workers: consequences of hand eczema. Br J Dermatol 2022; 187:609-611. [PMID: 35606939 PMCID: PMC9795892 DOI: 10.1111/bjd.21679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Yasemin Topal Yüksel
- Department of DermatologyBispebjerg & Frederiksberg Hospital, University of Copenhagen2400CopenhagenNVDenmark
| | - Sofie Marie Edslev
- Department of BacteriaParasites, and Fungi, Statens Serum Institut2300Copenhagen SDenmark
| | - Anne Klose Janstrup
- Department of DermatologyBispebjerg & Frederiksberg Hospital, University of Copenhagen2400CopenhagenNVDenmark
| | - Mie Sonne Goldeman
- Department of DermatologyBispebjerg & Frederiksberg Hospital, University of Copenhagen2400CopenhagenNVDenmark
| | - Line Brok Nørreslet
- Department of DermatologyBispebjerg & Frederiksberg Hospital, University of Copenhagen2400CopenhagenNVDenmark
| | - Paal Skytt Andersen
- Department of BacteriaParasites, and Fungi, Statens Serum Institut2300Copenhagen SDenmark
| | - Tove Agner
- Department of DermatologyBispebjerg & Frederiksberg Hospital, University of Copenhagen2400CopenhagenNVDenmark
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