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Rönsch H, Schiffers F, Ofenloch R, Weisshaar E, Buse AS, Hansen A, John SM, Giménez Arnau AM, Pesqué D, Agner T, Nørreslet LB, Loman L, Romeijn GLE, Schuttellaar MLA, Košćec Bjelajac A, Macan J, Apfelbacher C, Bauer A. Chronic hand eczema in Europe: Patient experiences and perspectives (CHEPEP) in qualitative interviews. J Eur Acad Dermatol Venereol 2023. [PMID: 36950901 DOI: 10.1111/jdv.19055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Chronic hand eczema (CHE) is a very common skin disease among the European population. It causes itch and pain and, in more severe cases, seriously impairs hand functioning at work and in private life. OBJECTIVES To explore perspectives of people with lived experience on CHE-related problems, wishes and goals. METHODS Following a qualitative approach, we conducted topic-guided interviews in five European countries and applied template analysis to identify recurrent themes among patients with CHE. RESULTS We interviewed 60 patients in 7 outpatient dermatological and occupational medicine clinics in Croatia, Denmark, Germany, the Netherlands, and Spain. Five main themes were identified: 1) knowledge about the disease and its course, 2) preventive behaviour, 3) hand eczema therapy, 4) impact on everyday life, 5) attitudes towards CHE and healthcare. Participants did not feel well informed about CHE, especially about causes, triggers, and treatment options. Preventive measures were experienced as more or less effective but also cumbersome. Experiences with therapy were diverse. Treatment satisfaction depended on the results and on the perceived support from the treatment teams. Participants found it important to be taken seriously, to receive practical advice, to try out additional treatments or examinations, find new hope, and have occupational perspectives. They wished that others could better understand the physical and emotional burden of CHE. Patient support groups were not mentioned. Participants found it important to learn to take care of themselves and accept life with CHE. CONCLUSIONS Due to its annoying symptoms, high visibility, and impaired functioning at work and in private life, CHE has a high emotional and social impact. Some people may require support to learn coping with CHE and its prevention. Patients wish for information about causes and triggers. They value physicians who listen to them and keep looking for solutions.
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Affiliation(s)
- H Rönsch
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - F Schiffers
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - R Ofenloch
- Section of Occupational Dermatology, Department of Dermatology, Ruprecht-Karls-University, Heidelberg, Germany
| | - E Weisshaar
- Section of Occupational Dermatology, Department of Dermatology, Ruprecht-Karls-University, Heidelberg, Germany
| | - A S Buse
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - A Hansen
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - S M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | | | - D Pesqué
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
| | - T Agner
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - L B Nørreslet
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - L Loman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - G L E Romeijn
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M L A Schuttellaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A Košćec Bjelajac
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - J Macan
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - C Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - A Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
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Ofenloch R, Weisshaar E. Handekzempatienten mit sehr schweren Beeinträchtigungen der
Lebensqualität: Dauer von Entstehung der Erkrankung bis zur Aufnahme
eines stationären Heilverfahrens erhöht. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bruze M, Engfeldt M, Elsner P, Gonçalo M, Naldi L, Schuttelaar MLA, Svedman C, Svensson Å, Ofenloch R. Validation of questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix II: the EDEN Fragrance Study. J Eur Acad Dermatol Venereol 2021; 35:1692-1701. [PMID: 33914959 DOI: 10.1111/jdv.17315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In a European study on contact allergy in the general population, it has been hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure and thereafter subsequent avoidance of scented products implied a diagnosis of allergic contact dermatitis. OBJECTIVES The primary aim of this study was to validate this hypothesis/algorithm. The secondary aim was to investigate whether there was any association between the outcome of the recent repeated open application test (ROAT) and the patch test reactivity. METHODS One hundred nine subjects with and without contact allergy to fragrance mix II (FM II) were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. RESULTS Twenty-four positive ROAT reactions were noted in total including 20 of those 32 with contact allergy to FM II. None of the volunteers reacted to the vehicle (P < 0.001). More individuals with a positive algorithm had positive ROATs when compared with those with a negative algorithm. However, the difference was not statistically significant (P = 0.12). The lower the patch test concentration eliciting a positive test reaction, the more likely was a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. CONCLUSIONS The algorithm used in this study was not validated but it was indicated in this ROAT setup. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period.
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Affiliation(s)
- M Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - M Engfeldt
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - P Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Naldi
- Centro Studi GISED - FROM Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - M L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - C Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Å Svensson
- Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - R Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
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4
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Rönsch H, Apfelbacher C, Brans R, Ofenloch R, Schuttelaar MLA, Weisshaar E, Bauer A. Protocol for the development of a core domain set for hand eczema trials. J Eur Acad Dermatol Venereol 2020; 34:2871-2876. [PMID: 32274874 DOI: 10.1111/jdv.16429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/24/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Clinical hand eczema trials measure a variety of outcome domains to determine the success of interventions. This considerably limits the comparability and overall confidence in the study results, and thereby the strength of recommendations for clinical practice. OBJECTIVES The Hand Eczema Core Outcome Set (HECOS) initiative aims to develop a core outcome set (COS) for the standardized evaluation of interventions in future hand eczema trials and reviews. This COS will define the minimum that should be measured and reported in controlled and randomized-controlled trials of therapeutic hand eczema interventions. The objective of this protocol is to specify the methods to develop a core domain set. METHODS In Phase 1, a list of candidate domains will be derived from a systematic literature review concerning previously measured outcomes in hand eczema trials, from qualitative patient interviews and from expert interviews. In Phase 2, a consensus study about core domains will be conducted by an online 3-round Delphi survey and a face-to-face meeting, applying predefined consensus criteria. HECOS involves hand eczema and methods experts as well as patients and further stakeholders with an interest in the initiative. OUTLOOK When a set of core domains has been defined, HECOS is going to identify appropriate outcome measurement instruments in a development process that will be detailed in another protocol. The COS will considerably enhance the methodological quality, comparability and usefulness of hand eczema trials for clinical decision-making and the development of new therapeutic options for hand eczema, and also reduce the effort of planning, conducting, and reporting individual hand eczema studies, reviews and meta-analyses.
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Affiliation(s)
- H Rönsch
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - C Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - R Brans
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - R Ofenloch
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls-University, Heidelberg, Germany
| | - M L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls-University, Heidelberg, Germany
| | - A Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
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5
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Bruze M, Engfeldt M, Ofenloch R, Elsner P, Goncalo M, Isaksson M, Naldi L, Schuttelaar M, Svensson Å, Diepgen T. Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I. Br J Dermatol 2019; 182:955-964. [DOI: 10.1111/bjd.18224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2019] [Indexed: 01/10/2023]
Affiliation(s)
- M. Bruze
- Department of Occupational and Environmental Dermatology Lund University Skåne University Hospital Malmö Sweden
| | - M. Engfeldt
- Department of Occupational and Environmental Dermatology Lund University Skåne University Hospital Malmö Sweden
| | - R. Ofenloch
- Department of Clinical Social Medicine University Hospital Heidelberg Heidelberg Germany
| | - P. Elsner
- Department of Dermatology University Hospital Jena Jena Germany
| | - M. Goncalo
- Department of Dermatology University Hospital and Faculty of Medicine University of Coimbra Coimbra Portugal
| | - M. Isaksson
- Department of Occupational and Environmental Dermatology Lund University Skåne University Hospital Malmö Sweden
| | - L. Naldi
- Centro Studi GISED – FROM Presidio Ospedaliero Matteo Rota Bergamo Italy
| | - M.‐L. Schuttelaar
- Department of Dermatology University of Groningen University Medical Center Groningen Groningen the Netherlands
| | - Å. Svensson
- Department of Dermatology Lund University Skåne University Hospital Malmö Sweden
| | - T. Diepgen
- Department of Clinical Social Medicine University Hospital Heidelberg Heidelberg Germany
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Apfelbacher C, Ofenloch R. Good evidence on measurement properties of the Dermatology Life Quality Index, Itchy Quality of Life and 5‐dimensions itch scales in atopic eczema, but problems with structural validity remain. Br J Dermatol 2019; 180:979-980. [DOI: 10.1111/bjd.17761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C.J. Apfelbacher
- Medical Sociology Institute of Epidemiology and Preventive Medicine University of Regensburg Regensburg Germany
| | - R. Ofenloch
- Department of Dermatology University Hospital Ruprecht‐Karl University of Heidelberg Germany
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Plewig N, Ofenloch R, Mettang T, Weisshaar E. The course of chronic itch in hemodialysis patients: results of a 4-year follow-up study of GEHIS (German Epidemiological Hemodialysis Itch Study). J Eur Acad Dermatol Venereol 2019; 33:1429-1435. [PMID: 30742721 DOI: 10.1111/jdv.15483] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 12/19/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Chronic itch (CI) is a frequent symptom in hemodialysis (HD) patients. Previous studies demonstrated great impairments of general well-being and health-related quality of life (HRQOL) as well as a higher mortality in those suffering from CI. OBJECTIVE The German Epidemiological Hemodialysis Itch Study (GEHIS) is a representative cohort of HD patients in Germany. All patients were followed up 4 years later. The current analyses present data on the course of CI in HD patients, its associated factors including comorbidities, laboratory values and HRQOL. METHODS We assessed sociodemographic data, routine laboratory values, comorbidities, HRQOL (SF-12), depression and anxiety (HADS), sleep (duration and quality) and in those suffering from CI characteristics, intensity of CI and itch-related quality of life (ItchyQoL). Those with CI were offered a dermatological examination and CI was classified according to the IFSI classification. Patients were asked if they had consulted a physician about CI. RESULTS Of the patients who had suffered from CI in 2013 (n = 234), 90.5% (212) patients could be followed up. About 36.3% (n = 85) had died, 9.8% (n = 23) had received a kidney transplant in the meantime. A total of 52 HD patients still suffered from CI, in 52 CI had stopped. Those patients still suffering from CI (n = 52) reported a higher mean itch intensity, lower ItchyQoL, higher levels of anxiety and a lower mean sleeping time in 2013. On the other hand, those who did not suffer from CI anymore showed a significant increase of HRQOL compared to 2013. There was no significant difference in dialysis characteristics and laboratory values except for albumin. Only a minority of patients in HD had consulted a dermatologist because of CI (29.9%). CONCLUSION Our data demonstrate that CI is a persisting symptom in 50% of the HD patients and when it disappears HRQOL recovers. We confirm that CI is a disregarded symptom in HD patients.
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Affiliation(s)
- N Plewig
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, Ruprecht Karls University, University Hospital Heidelberg, Heidelberg, Germany
| | - R Ofenloch
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, Ruprecht Karls University, University Hospital Heidelberg, Heidelberg, Germany
| | - T Mettang
- Department of Nephrology, DKD Helios Clinic, Wiesbaden, Germany
| | - E Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, Ruprecht Karls University, University Hospital Heidelberg, Heidelberg, Germany
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Heinl D, Prinsen CAC, Sach T, Drucker AM, Ofenloch R, Flohr C, Apfelbacher C. Measurement properties of quality-of-life measurement instruments for infants, children and adolescents with eczema: a systematic review. Br J Dermatol 2017; 176:878-889. [PMID: 27543747 DOI: 10.1111/bjd.14966] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Quality of life (QoL) is one of the core outcome domains identified by the Harmonising Outcome Measures for Eczema (HOME) initiative to be assessed in every eczema trial. There is uncertainty about the most appropriate QoL instrument to measure this domain in infants, children and adolescents. OBJECTIVES To systematically evaluate the measurement properties of existing measurement instruments developed and/or validated for the measurement of QoL in infants, children and adolescents with eczema. METHODS A systematic literature search in PubMed and Embase, complemented by a thorough hand search of reference lists, retrieved studies on measurement properties of eczema QoL instruments for infants, children and adolescents. For all eligible studies, we judged the adequacy of the measurement properties and the methodological study quality with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Results from different studies were summarized in a best-evidence synthesis and formed the basis to assign four degrees of recommendation. RESULTS Seventeen articles, three of which were found by hand search, were included. These 17 articles reported on 24 instruments. No instrument can be recommended for use in all eczema trials because none fulfilled all required adequacy criteria. With adequate internal consistency, reliability and hypothesis testing, the U.S. version of the Childhood Atopic Dermatitis Impact Scale (CADIS), a proxy-reported instrument, has the potential to be recommended depending on the results of further validation studies. All other instruments, including all self-reported ones, lacked significant validation data. CONCLUSIONS Currently, no QoL instrument for infants, children and adolescents with eczema can be highly recommended. Future validation research should primarily focus on the CADIS, but also attempt to broaden the evidence base for the validity of self-reported instruments.
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Affiliation(s)
- D Heinl
- Department of Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany
| | - C A C Prinsen
- VU University Medical Center, Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, Amsterdam, the Netherlands
| | - T Sach
- Norwich Medical School, University of East Anglia, Norwich, U.K
| | - A M Drucker
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, U.S.A
| | - R Ofenloch
- Department of Clinical Social Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - C Flohr
- St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - C Apfelbacher
- Department of Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany.,Division of Public Health and Primary Care, Brighton and Sussex Medical School, Falmer, U.K
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Ofenloch R, Apfelbacher C, Weisshaar E, Molin S, Bauer A, Mahler V, Elsner P, Diepgen T. Determinanten der Lebensqualität von Patienten mit chronischem Handekzem im 2-Jahres Verlauf. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Heinl D, Prinsen CAC, Deckert S, Chalmers JR, Drucker AM, Ofenloch R, Humphreys R, Sach T, Chamlin SL, Schmitt J, Apfelbacher C. Measurement properties of adult quality-of-life measurement instruments for eczema: a systematic review. Allergy 2016; 71:358-70. [PMID: 26564008 DOI: 10.1111/all.12806] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Harmonising Outcome Measures for Eczema (HOME) initiative has identified quality of life (QoL) as a core outcome domain to be evaluated in every eczema trial. It is unclear which of the existing QoL instruments is most appropriate for this domain. Thus, the aim of this review was to systematically assess the measurement properties of existing measurement instruments developed and/or validated for the measurement of QoL in adult eczema. METHODS We conducted a systematic literature search in PubMed and Embase identifying studies on measurement properties of adult eczema QoL instruments. For all eligible studies, we assessed the adequacy of the measurement properties and the methodological quality with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis summarizing findings from different studies was the basis to assign four degrees of recommendation (A-D). RESULTS A total of 15 articles reporting on 17 instruments were included. No instrument fulfilled the criteria for category A. Six instruments were placed in category B, meaning that they have the potential to be recommended depending on the results of further validation studies. Three instruments had poor adequacy in at least one required adequacy criterion and were therefore put in category C. The remaining eight instruments were minimally validated and were thus placed in category D. CONCLUSIONS Currently, no QoL instrument can be recommended for use in adult eczema. The Quality of Life Index for Atopic Dermatitis (QoLIAD) and the Dermatology Life Quality Index (DLQI) are recommended for further validation research.
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Affiliation(s)
- D. Heinl
- Medical Sociology; Department of Epidemiology and Preventive Medicine; University of Regensburg; Regensburg Germany
| | - C. A. C. Prinsen
- VU University Medical Center; Department of Epidemiology and Biostatistics; EMGO+ Institute for Health and Care Research; Amsterdam The Netherlands
| | - S. Deckert
- Centre for Evidence-based Healthcare; Medizinische Fakultät Carl Gustav Carus; TU Dresden; Dresden Germany
| | - J. R. Chalmers
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
| | - A. M. Drucker
- Division of Dermatology; University Health Network; Toronto ON Canada
| | - R. Ofenloch
- Department of Clinical Social Medicine; University Hospital Heidelberg; Heidelberg Germany
| | | | - T. Sach
- Norwich Medical School; University of East Anglia; Norwich UK
| | - S. L. Chamlin
- Ann and Robert H. Lurie Children's Hospital of Chicago; Northwestern University Feinberg School of Medicine; Chicago IL USA
| | - J. Schmitt
- Centre for Evidence-based Healthcare; Medizinische Fakultät Carl Gustav Carus; TU Dresden; Dresden Germany
| | - C. Apfelbacher
- Medical Sociology; Department of Epidemiology and Preventive Medicine; University of Regensburg; Regensburg Germany
- Division of Public Health and Primary Care; Brighton and Sussex Medical School; Falmer UK
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Diepgen T, Ofenloch R, Bruze M, Cazzaniga S, Coenraads PJ, Elsner P, Goncalo M, Svensson Å, Naldi L. Colophony as a marker for fragrance allergy in the general European population. Br J Dermatol 2016; 174:695-6. [DOI: 10.1111/bjd.14297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T.L. Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology; University Heidelberg; Thibautstraße 3 69115 Heidelberg Germany
| | - R. Ofenloch
- Department of Social Medicine, Occupational and Environmental Dermatology; University Heidelberg; Thibautstraße 3 69115 Heidelberg Germany
| | - M. Bruze
- Department of Occupational and Environmental Dermatology; Skåne University Hospital; Lund University; Malmö Sweden
| | - S. Cazzaniga
- Department of Dermatology; Azienda Ospedaliera Papa Giovanni XXIII, Bergamo; Centro Studi GISED - FROM Presidio Ospedaliero Matteo Rota; Via Garibaldi 13/15 24122 Bergamo Italy
| | - P.-J. Coenraads
- Department of Dermatology; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - P. Elsner
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - M. Goncalo
- Department of Dermatology; Coimbra University Hospital; Faculty of Medicine; University of Coimbra; Coimbra Portugal
| | - Å. Svensson
- Department of Dermatology; Skåne University Hospital; Lund University; Malmö Sweden
| | - L. Naldi
- Department of Dermatology; Azienda Ospedaliera Papa Giovanni XXIII, Bergamo; Centro Studi GISED - FROM Presidio Ospedaliero Matteo Rota; Via Garibaldi 13/15 24122 Bergamo Italy
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12
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Diepgen TL, Ofenloch R, Bruze M, Cazzaniga S, Coenraads PJ, Elsner P, Goncalo M, Svensson Å, Naldi L. Prevalence of fragrance contact allergy in the general population of five European countries: a cross-sectional study. Br J Dermatol 2015; 173:1411-9. [PMID: 26332456 DOI: 10.1111/bjd.14151] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Contact allergy to fragrances is assessed mostly in clinical populations of patients. Studies in the general population are scarce and vary in their methodology across countries. OBJECTIVES To determine the prevalence of fragrance contact allergy in the European general population and to assess the clinical relevance of positive patch test reactions to different fragrances. METHODS In five European countries (Germany, Italy, the Netherlands, Portugal and Sweden) a random sample from the general population aged 18-74 years was drawn. In total, 12 377 subjects were interviewed in this cross-sectional study and a random sample (n = 3119) was patch tested using the TRUE Test and Finn Chamber techniques. Patch test procedures were harmonized by mandatory training before the study and monitoring during the study. RESULTS The highest prevalence for contact allergy of 2·6% [95% confidence interval (CI) 2·1-3·2] was found for fragrance mix (FM) I in petrolatum, with a high content of atranol and chloratranol, followed by 1·9% (95% CI 1·5-2·4) for FM II in petrolatum. The conservatively estimated prevalence of fragrance contact allergy was 1·9% (95% CI 1·5-2·5). This is defined as the existence of a positive patch test to FM I or FM II; any of their individual materials; Myroxylon pereirae; sesquiterpene lactones or 3- and 4-hydroxyisohexyl 3-cyclohexene carboxaldehyde that show clinical relevance, defined conservatively as lifetime avoidance of scented products and an itchy skin rash lasting > 3 days in a lifetime. Using the reported lifetime prevalence of any contact dermatitis instead of the lifetime prevalence of any itchy skin rash, the prevalence is 0·8% (95% CI 0·5-1·2). The prevalence rates of contact allergy to fragrances in women are about twice those in men. CONCLUSIONS This study helps to identify targets for prevention of fragrance allergy.
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Affiliation(s)
- T L Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Thibautstraße 3, 69115, Heidelberg, Germany
| | - R Ofenloch
- Department of Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Thibautstraße 3, 69115, Heidelberg, Germany
| | - M Bruze
- Department of Occupational and Environmental Dermatology, University Hospital Malmö, S-20502, Malmö, Sweden
| | - S Cazzaniga
- Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Centro Studi GISED - FROM Presidio Ospedaliero Matteo Rota, Via Garibaldi 13/15, 24122, Bergamo, Italy
| | - P J Coenraads
- Occupational and Environmental, Dermatology Unit, State University Hospital, P.O. Box 30.001, NL-9700 RB, Groningen, the Netherlands
| | - P Elsner
- Klinik für Dermatologie und dermatologische Allergologie, Klinikum der FSU Jena, Erfurter Str. 35, D-07740, Jena, Germany
| | - M Goncalo
- Clinica de Dermatologia, Hospital da Universidade Praceta Motal Pinto, Rua Infanta D.Maria, n 30-A-3D, P-3000-075, Coimbra, Portugal
| | - Å Svensson
- Department of Dermatology, University Hospital Malmö, S-20502, Malmö, Sweden
| | - L Naldi
- Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Centro Studi GISED - FROM Presidio Ospedaliero Matteo Rota, Via Garibaldi 13/15, 24122, Bergamo, Italy
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Eubel J, Ofenloch R, Weisshaar E, Diepgen T. Auswirkung der atopischen Hautdiathese auf die Entstehung einer berufsbedingten Hautkrankheit. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1386893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ofenloch R, Diepgen T, Molin S, Weisshaar E, Bauer A, Mahler V, Elsner P, Apfelbacher C. Validität und Reliabilität der deutschen Version des Occupational Contact Dermatitis Disease Severity Index (ODDI). Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1386982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ofenloch R, Weisshaar E, Diepgen T. Analyse der Messeigenschaften des Erlangener Atopie-Score gemäß den Anforderungen der modernen Testtheorie. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1386983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ofenloch R, Diepgen T, Weisshaar E, Apfelbacher C. The Quality of Life in hand eczema questionnaire: validation of a new assessment instrument. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1354185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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