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Eriksson TBJ, Isaksson M, Engfeldt M, Dahlin J, Tegner Y, Ofenloch R, Bruze M. Contact allergy in Swedish professional ice hockey players. Contact Dermatitis 2024; 90:574-584. [PMID: 38501375 DOI: 10.1111/cod.14529] [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: 08/10/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Professional ice hockey players may contract irritant and allergic contact dermatitis. AIMS To investigate the presence of contact allergy (CA) in professional ice hockey players in Sweden. METHODS Ten teams from the two top leagues were assessed for potential occupational exposure to sensitizers. Exactly 107 players were patch tested with an extended baseline series and a working series, in total 74 test preparations. The CA rates were compared between the ice hockey players and controls from the general population and dermatitis patients. RESULTS One out of 4 players had at least one contact allergy. The most common sensitizers were Amerchol L 101, nickel and oxidized limonene. CA was as common in the ice hockey players as in dermatitis patients and significantly more common than in the general population. Fragrances and combined sensitizers in cosmetic products (fragrances + preservatives + emulsifier) were significantly more common in ice hockey players compared with the general population. CONCLUSION The possible relationship between CA to fragrances and cosmetic products on the one hand and the presence of dermatitis on the other should be explored further.
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Affiliation(s)
- Tomas B J Eriksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Yelverton Tegner
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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2
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Ofenloch R, Weisshaar E. [Selected aspects regarding social factors in skin diseases]. Dermatologie (Heidelb) 2024; 75:386-391. [PMID: 38639767 DOI: 10.1007/s00105-024-05335-6] [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] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/20/2024]
Abstract
Skin diseases are complex and cannot be explained solely by genetic or environmental factors but are also significantly shaped by social influences. This review illuminates the bidirectional relationship between social factors and skin diseases, demonstrating how social determinants such as socioeconomic status, living environment, and psychosocial stress can influence the onset and progression of skin conditions. Simultaneously, it explores how skin diseases can affect individuals' social lives and work capability, leading to a cycle of social withdrawal and further deterioration of the condition. The paper describes the need for a holistic approach in dermatology that goes beyond the biomedical perspective and incorporates social factors to develop effective prevention and treatment strategies. The increasing prevalence of skin diseases in Europe and the expected rise in allergies due to climate change make the consideration of social determinants even more urgent. The findings of this review aim to raise awareness of the complex interconnections between social factors and skin health and contribute to reducing social disparities in skin health.
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Affiliation(s)
- Robert Ofenloch
- Sektion Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland.
| | - Elke Weisshaar
- Sektion Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland
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3
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Ulriksdotter J, Sukakul T, Bruze M, Mowitz M, Ofenloch R, Svedman C. Contact Allergy to Allergens in the Swedish Baseline Series Overrepresented in Diabetes Patients with Skin Reactions to Medical Devices - A Retrospective Study from Southern Sweden. Acta Derm Venereol 2024; 104:adv19676. [PMID: 38551376 PMCID: PMC11000652 DOI: 10.2340/actadv.v104.19676] [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: 09/27/2023] [Accepted: 01/23/2024] [Indexed: 04/02/2024] Open
Abstract
Allergic contact dermatitis is reported among individuals using continuous glucose monitoring systems and insulin pumps. The aim of this study was to describe contact allergy patterns for allergens in the Swedish baseline series and medical device-related allergens among users. Contact allergy to baseline series allergens and isobornyl acrylate was compared between diabetes patients and dermatitis patients patch-tested at the Department of Occupational and Environmental Dermatology during 2017 to 2020. Fifty- four diabetes patients and 2,567 dermatitis patients were included. The prevalence of contact allergy to fragrance mix II and sesquiterpene lactone mix was significantly higher in diabetes patients compared with dermatitis patients. Of the diabetes patients 13.0% and of the dermatitis patients 0.5% tested positive to sesquiterpene lactone mix (p < 0.001). Of the diabetes patients 7.4% and of the dermatitis patients 2.3% tested positive to fragrance mix II (p = 0.041). Of the diabetes patients 70.4% tested positive to medical device-related allergens. Of the diabetes patients 63.0% and of the dermatitis patients 0.2% were allergic to isobornyl acrylate (p < 0.001). In conclusion, not only medical device-related contact allergies, but also contact allergy to baseline series allergens (fragrance mix II and sesquiterpene lactone mix), is overrepresented in diabetes patients who use medical devices.
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Affiliation(s)
- Josefin Ulriksdotter
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden .
| | - Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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4
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Cassalia F, Cazzaniga S, Ofenloch R, Elsner P, Gonçalo M, Schuttelaar ML, Svensson Å, Pezzolo E, Bruze M, Naldi L. Comparison of Perceptions of Skin Condition, Product Use and Allergen Reactivity Between People with Psoriasis and Controls in the European Dermato-Epidemiology Network (EDEN) Fragrance Study. Acta Derm Venereol 2024; 104:adv23513. [PMID: 38436432 PMCID: PMC10924268 DOI: 10.2340/actadv.v104.23513] [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: 10/13/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Psoriasis, a chronic inflammatory skin disease, goes beyond visible symptoms and affects the general well-being of patients. The aim of this study is to understand how patients with psoriasis perceive their skin characteristics and reactivity to allergens. The study population includes 11,283 participants within the European Dermato-Epidemiology Network (EDEN) Fragrance study, covering several European regions. The study compared perceptions of skin dryness, sensitivity, product avoidance and reactivity to allergens between patients with psoriasis and controls, evaluating the potential influence of psoriasis severity. The results showed that subjects with psoriasis reported dry skin (71.1%) and sensitive skin (49.4%) more often than did controls (51.6% and 38.5%, respectively). Psoriasis patients were more likely to avoid specific products. Interestingly, there were no significant differences in patch-test results between the 2 groups and the severity of psoriasis did not have a consistent impact on these perceptions. In conclusion, people with psoriasis tend to perceive their skin as drier and more sensitive. Notably, the severity of psoriasis did not consistently influence these perceptions and objective reactivity to allergens did not align with subjective perception. Understanding these aspects is crucial for tailoring treatments to improve the well-being of patients with psoriasis, which warrants further research to explore subjective perceptions of skin well-being in patients with psoriasis.
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Affiliation(s)
- Fortunato Cassalia
- Centro Studi GISED, Bergamo, Italy; Dermatology Unit, Department of Medicine, University of Padova, Padua, Italy
| | - Simone Cazzaniga
- Centro Studi GISED, Bergamo, Italy; Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Robert Ofenloch
- University Hospital Heidelberg, Section of Occupational Dermatology, Department of Dermatology, Germany
| | - Peter Elsner
- Dermatology, Allergology, Dermatopathology, SRH- Klinikum Gera, Germany
| | - Margarida Gonçalo
- University Hospital, Department of Dermatology; Faculty of Medicine, University of Coimbra, Dermatology, Portugal
| | | | - Åke Svensson
- University Hospital, Lund University, Department of Dermatology, Malmö, Sweden
| | - Elena Pezzolo
- 1. Centro Studi GISED, Bergamo, Italy; 2. Department of Dermatology, Ospedale San Bortolo, Vicenza, Italy
| | - Magnus Bruze
- Skåne University Hospital, Department of Occupational and Environmental Dermatology, Malmö, Sweden
| | - Luigi Naldi
- 1.Centro Studi GISED, Bergamo, Italy; 2. Department of Dermatology, Ospedale San Bortolo, Vicenza, Italy.
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5
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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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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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7
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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, Schuttelaar MLA, Košćec Bjelajac A, Macan J, Bauer A, Apfelbacher CJ. Which outcomes should be measured in hand eczema trials? Results from patient interviews and an expert survey. J Eur Acad Dermatol Venereol 2023; 37:1199-1206. [PMID: 36695080 DOI: 10.1111/jdv.18923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Hand eczema (HE) is a common skin disease characterized by itch, pain and visible skin changes such as fissures, erythema and vesicles. It is not yet clear which outcome domains are most important for patients. The Hand Eczema Core Outcome Set (HECOS) initiative is developing a consented set of core domains and suitable measurement instruments for the future application in all HE trials. This includes an online Delphi survey about core domains, which requires a 'Long List' of all domains that might be important to measure. OBJECTIVES To compile a 'Long List' of candidate outcome domains for therapeutic HE trials with suggestions from patients and experts. METHODS First, 60 patients with chronic HE were interviewed at seven study sites in Croatia, Denmark, Germany, the Netherlands and Spain. Patients were asked about domains that were important from their perspectives. Second, 185 HE experts were invited by email to complete an online survey. With an open question, they were asked to suggest up to six domains. RESULTS Suggestions were provided by 58 patients and 82 experts. Most patients and experts suggested to measure the domains 'signs', 'symptoms' and 'HE-related quality of life'. Specifically, >25% of patients said that less itch, pain or fissures indicated a successful treatment. Among experts, >25% suggested 'itch' and 'ability to work' as core sub-domains. Further outcomes from the domains 'HE control over time', 'patient-reported treatment experience' and 'skin barrier function' were mentioned. CONCLUSION 'Itch' was rated high among patients with HE and professional HE experts. While patients emphasized fissures as important, experts underlined the ability to work. This investigation allowed us to define a 'Long List' of 7 candidate outcome domains with 58 sub-domains. From this list, a panel of stakeholders will select core domains during an online Delphi survey.
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Affiliation(s)
- Henriette Rönsch
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Frederike Schiffers
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls-University, Heidelberg, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls-University, Heidelberg, Germany
| | - Anna-Sophie Buse
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Andreas Hansen
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Ana M Giménez Arnau
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - David Pesqué
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - Tove Agner
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Line Brok Nørreslet
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Laura Loman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Geertruida L E Romeijn
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Adrijana Košćec Bjelajac
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Jelena Macan
- Occupational Health and Environmental Medicine Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian J Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
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Bruze M, Hopkins K, Dahlin J, Olsson K, Åstrand J, Svedman C, Ofenloch R, Antelmi A. Increased rates of fragrance allergy in fibromyalgia individuals tested with the Swedish baseline patch test series. J Eur Acad Dermatol Venereol 2023; 37:104-113. [PMID: 36018078 DOI: 10.1111/jdv.18562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/27/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Contact allergy can manifest in a variety of ways clinically. Systemic contact allergy may occasionally present with pain in muscles and joints. Fibromyalgia is a chronic rheumatic disease characterized by pain and with virtually unknown aetiology. OBJECTIVES The aim of this study was to investigate the contact allergy rates to the sensitizers in a baseline series and compare with corresponding rates in dermatitis patients and the general population. METHODS Patch testing with the Swedish baseline series was performed in 120 individuals with fibromyalgia. Fisher's exact test was used for pair-wise comparisons of contact allergy rates between the fibromyalgia group and two control groups, dermatitis patients and individuals in the general population. RESULTS Contact allergy was significantly more common in the fibromyalgia group compared to the general population concerning nickel and the fragrance markers Myroxolon pereirae and fragrance mix I. There were fewer allergic reactions to preservatives in the fibromyalgia group compared with the dermatitis group. CONCLUSIONS Myroxolon pereirae and fragrance mix I represent besides fragrance allergy also allergy to flavouring substances which indicate that oral exposure to flavouring substances and hygiene products might be important for sensitization and possibly elicitation of systemic contact allergy symptoms in fibromyalgia individuals.
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Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Karin Olsson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jacqueline Åstrand
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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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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Yüksel YT, Ibler K, Agner T, Ofenloch R. Validation of the Danish version of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ). Br J Dermatol 2022; 187:256-258. [PMID: 35104365 DOI: 10.1111/bjd.21041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/24/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Yasemin Topal Yüksel
- Department of Dermatology, Frederiksberg Hospital, University of Copenhagen, Bispebjerg &, 2400, Copenhagen, Denmark
| | - Kristina Ibler
- Department of Dermatology, Roskilde Hospital, University of Copenhagen, 4000, Roskilde, Denmark
| | - Tove Agner
- Department of Dermatology, Frederiksberg Hospital, University of Copenhagen, Bispebjerg &, 2400, Copenhagen, Denmark
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, 69115, Heidelberg, Germany
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Ofenloch R, Grochulska K, Mettang T, Weisshaar E. The incidence of chronic itch in hemodialysis patients and factors associated. Br J Dermatol 2022; 186:1052-1054. [PMID: 35048359 DOI: 10.1111/bjd.21024] [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] [Received: 07/06/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University, Heidelberg, Germany
| | - Katarzyna Grochulska
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University, Heidelberg, Germany
| | - Thomas Mettang
- Department of Nephrology, DKD Helios Clinic, Wiesbaden, Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karls University, Heidelberg, Germany
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Uter W, Zetzmann A, Ofenloch R, Schliemann S, Bruze M, Gonçalo M, Naldi L, Schuttelaar MLA, Svensson Å, Elsner P. Prevalence of contact allergies in the population compared to a tertiary referral patch test clinic in Jena/Germany. Contact Dermatitis 2021; 85:563-571. [PMID: 34184275 DOI: 10.1111/cod.13923] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The contact allergy prevalences in patch-tested patients are usually higher than those in the population, owing to morbidity-driven selection. OBJECTIVES To examine the differences between two samples, one from the population, one from the patch test clinic, in one area of Germany (Jena, Thuringia). METHODS Between August 2008 and October 2011, a total of 519 participants of the population-based european dermato-epidemiology network (EDEN) fragrance study were patch tested in Jena using a TRUE Test baseline series extended with some pet.-based (fragrance) allergen preparations. Between 2007 and 2012 (inclusive), 1906 routine patients were patch tested for suspected allergic contact dermatitis (ACD) in the Jena University Hospital Department; of these 1694 (83.2%) with the German baseline series using pet./aq.-based, investigator-loaded allergens. RESULTS In the population (clinical) sample, 19.6% (41.1%) were sensitized to at least one of the allergens considered. The most common baseline series allergens in the population/clinical sample were nickel (10.5%/13.2%), fragrance mix (FM) II (2.9%/6.7%), FM I (2.3%/8.3%), and cobalt (1.6%/5%). The clinical sample was slightly older (71.5% vs 55.9% age 40+) and included less males (36% vs 49.3%). CONCLUSIONS Results are quite similar, although prevalences are usually higher in the clinical setting, with the exception of p-tert-butylphenol formaldehyde resin.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Anica Zetzmann
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Luigi Naldi
- Department of Dermatology, AULSS8 Ospedale San Bortolo di Vicenza, Vicenza, Italy.,Centro Studi GISED, Bergamo, Italy
| | - Marie-Louise A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Åke Svensson
- Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
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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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Ofenloch R, Oesterhelt A, Weisshaar E. Das medizinisch‐berufliche Rehabilitationsverfahren Haut am Universitätsklinikum Heidelberg: Anstieg von Krankheitsdauer und Lebensalter der Patienten. J Dtsch Dermatol Ges 2021; 19:746-749. [PMID: 33979055 DOI: 10.1111/ddg.14444_g] [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: 11/29/2022]
Affiliation(s)
- Robert Ofenloch
- Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg
| | | | - Elke Weisshaar
- Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg
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Ofenloch R, Oesterhelt A, Weisshaar E. Rehabilitation program for occupational skin diseases at the University Hospital Heidelberg, Germany: increase in disease duration and age of patients. J Dtsch Dermatol Ges 2021; 19:746-749. [PMID: 33932094 DOI: 10.1111/ddg.14444] [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)
- Robert Ofenloch
- Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg
| | | | - Elke Weisshaar
- Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg
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16
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Yüksel YT, Agner T, Ofenloch R. New evidence on the minimal important change (MIC) for the Hand Eczema Severity Index (HECSI). Contact Dermatitis 2021; 85:164-170. [PMID: 33656746 DOI: 10.1111/cod.13828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND How changes in hand eczema (HE) severity correlate with the single scores on the Hand Eczema Severity Index (HECSI) is sparsely investigated and particularly needed in clinical trials. OBJECTIVES To find the minimal important change (MIC) for HECSI based on patient's and physician's assessments using different methods. METHODS In this prospective follow-up study, three different anchors were used: two anchor questions for patients and physician, respectively, and the Physician Global Assessment (PGA) with a photographic guide. MIC was estimated by mean change in patients with a one-step increase to anchor-questions, receiver-operating characteristic (ROC) plot, and smallest detectable change (SDC). RESULTS One hundred fifty-two patients with HE (63.8% female) were included at baseline (89% completed follow-up). The mean change, ROC cutoff, and SDC values were 7.1, 4.5, 21.4 (patient-rating), 8.2, 4.5, 8.3 (physician-rating), and 16.6, 6.5, 27.1 points (PGA), respectively. SDC stratified by baseline severity was 2.9 and 11 points for mild and moderate-severe HE (physician-rating), respectively. CONCLUSION Identification of the MIC for the HECSI is important in relation to evaluation of treatment, intervention, and sample-size calculations. An improvement of 8.3 points on the HECSI is recommended as the MIC. MIC values may differ according to baseline severity, and this variation should be clarified in future studies.
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Affiliation(s)
- Yasemin Topal Yüksel
- Department of Dermatology, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tove Agner
- Department of Dermatology, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Robert Ofenloch
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
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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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18
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van Amerongen CCA, Ofenloch R, Dittmar D, Schuttelaar MLA. New positive patch test reactions on day 7-The additional value of the day 7 patch test reading. Contact Dermatitis 2019; 81:280-287. [PMID: 31116435 PMCID: PMC6771944 DOI: 10.1111/cod.13322] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/15/2019] [Accepted: 05/21/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Not performing a day (D) 7 patch test reading might result in positive patch test reactions being missed. OBJECTIVES To investigate the added value of the D7 patch test reading for individual allergens, and to identify patient characteristics and allergen groups associated with new positive D7 reactions. METHODS Data from patients patch tested between 2008 and 2018 with the extended European baseline series were analysed. Patch test readings were performed on D3 and D7. Positive reactions were categorized into positive on D3 or new positive on D7. RESULTS A total of 3292 patients were consecutively patch tested with at least 43 allergens of the TRUE Test panels 1 and 2 supplemented with investigator-loaded allergens. In total, 447 (13.6%) patients showed new positive D7 reactions. In univariable regression analysis, age between 18 and 30 years showed a negative association with new positive D7 reactions. Significantly more D7 positive reactions were seen for topicals (odds ratio [OR] 2.60, 95% confidence interval [CI]: 1.92-3.51) and corticosteroids (OR 1.87, 95%CI: 1.09-3.21). No associations were found between sex, atopic dermatitis and occupational dermatitis and a new positive D7 reaction. CONCLUSION A D7 reading to identify new positive patch test reactions is of added value, especially for topicals and corticosteroids.
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Affiliation(s)
- Cynthia C. A. van Amerongen
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - Robert Ofenloch
- Department of Social Medicine, Occupational and Environmental DermatologyUniversity of HeidelbergHeidelbergGermany
| | - Daan Dittmar
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
| | - Marie L. A. Schuttelaar
- Department of DermatologyUniversity of Groningen, University Medical Centre GroningenGroningenThe Netherlands
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19
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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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Abstract
BACKGROUND Population-based studies on hand eczema (HE) show a 1-year prevalence up to 10.0% of which 5-7% are severe chronic HE (CHE) which can severely impair the life of those affected. Registry data can help to investigate and optimize burden of disease as well as healthcare of HE in a real-life setting. OBJECTIVES To assess how data from registries have been used in studies concerning HE. What is the benefit of registry data and which limitations occur when researchers use registry data in their studies? MATERIALS AND METHODS This is a review of publications where registry data were used in studies concerning HE. Most of the publications included in this review are from Germany, but some studies are from other countries like Denmark and Switzerland. RESULTS Currently, only Germany and Switzerland have established a disease-specific registry for CHE. The chronic hand eczema registry with the acronym CARPE assesses the characteristics of CHE as well as treatment and course of the diseases in a real-life setting. In Denmark, data from public registries (Danish National Board of Industrial Injuries Registry) were used to identify patients with occupational HE in order interview them using a questionnaire. In Saarland and north Bavaria, registries for occupational skin diseases were established in the 1990s, and more than 90% of the patients registered in these had HE. CONCLUSION Diseases registries for HE can generate considerable data to describe characteristics of HE patients in a dermatological setting as well as the treatments prescribed. The completeness of data can be assessed in disease registries, while this is not possible when using public registry data.
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Affiliation(s)
- Robert Ofenloch
- Abteilung Klinische Sozialmedizin, Universitätsklinikum Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland.
| | - Christian Apfelbacher
- Medizinische Soziologie, Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg, Deutschland
| | - Elke Weisshaar
- Abteilung Klinische Sozialmedizin, Universitätsklinikum Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland
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21
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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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22
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Bruze M, Mowitz M, Ofenloch R, Coenraads P, Diepgen TL, Elsner P, Gonçalo M, Naldi L, Svensson Å. The significance of batch and patch test method in establishing contact allergy to fragrance mix I—EDEN Fragrance Study Group. Contact Dermatitis 2019; 81:104-109. [DOI: 10.1111/cod.13253] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Magnus Bruze
- Department of Occupational and Environmental DermatologySkåne University Hospital, Lund University Malmö Sweden
| | - Martin Mowitz
- Department of Occupational and Environmental DermatologySkåne University Hospital, Lund University Malmö Sweden
| | - Robert Ofenloch
- Department of Social MedicineOccupational and Environmental Dermatology, University of Heidelberg Heidelberg Germany
| | - Pieter‐Jan Coenraads
- Department of Dermatology, University of GroningenUniversity Medical Centre Groningen Groningen The Netherlands
| | - Thomas L. Diepgen
- Department of Social MedicineOccupational and Environmental Dermatology, University of Heidelberg Heidelberg Germany
| | - Peter Elsner
- Department of DermatologyUniversity Hospital Jena Jena Germany
| | - Margarida Gonçalo
- Clinic of DermatologyUniversity Hospital and Faculty of Medicine, University of Coimbra Coimbra Portugal
| | - Luigi Naldi
- Department of Dermatology, Azienda Ospedaliera papa Giovanni XXIII, BergamoCentro Studi GISED—FROM Presidio Ospedaliero Matteo Rota Bergamo Italy
| | - Åke Svensson
- Department of DermatologySkåne University Hospital, Lund University Malmö Sweden
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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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Rönsch H, Apfelbacher C, Brans R, Matterne U, Molin S, Ofenloch R, Oosterhaven JAF, Schuttelaar MLA, Weisshaar E, Yew YW, Bauer A. Which outcomes have been measured in hand eczema trials? A systematic review. Contact Dermatitis 2019; 80:201-207. [DOI: 10.1111/cod.13212] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Henriette Rönsch
- Department of DermatologyUniversity Hospital Carl Gustav Carus, Technical University Dresden Dresden Germany
| | - Christian Apfelbacher
- Medical Sociology, Department of Epidemiology and Preventive MedicineUniversity of Regensburg Regensburg Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück Osnabrück Germany
| | - Uwe Matterne
- Medical Sociology, Department of Epidemiology and Preventive MedicineUniversity of Regensburg Regensburg Germany
| | - Sonja Molin
- Division of DermatologyDepartment of Medicine, Queen's University Kingston Canada
| | - Robert Ofenloch
- Occupational Dermatology, Department of DermatologyRuprecht‐Karls‐University Heidelberg Germany
| | - Jart A. F. Oosterhaven
- Department of DermatologyUniversity of Groningen, University Medical Centre Groningen Groningen The Netherlands
| | - Marie L. A. Schuttelaar
- Department of DermatologyUniversity of Groningen, University Medical Centre Groningen Groningen The Netherlands
| | - Elke Weisshaar
- Occupational Dermatology, Department of DermatologyRuprecht‐Karls‐University Heidelberg Germany
| | - Yik Weng Yew
- National Skin CentreInstitute of Dermatology Singapore Singapore
| | - Andrea Bauer
- Department of DermatologyUniversity Hospital Carl Gustav Carus, Technical University Dresden Dresden Germany
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25
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Gina M, Ofenloch R, Diepgen TL, Elsner P. Qualität von Sachverständigengutachten zum berufsbedingten Hautkrebs durch natürliches UV-Licht. J Dtsch Dermatol Ges 2017; 15:1243-1246. [DOI: 10.1111/ddg.13371_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Michal Gina
- Klinik für Hautkrankheiten; Universitätsklinikum Jena
| | - Robert Ofenloch
- Abteilung Klinische Sozialmedizin; Universitätsklinikum Heidelberg
| | | | - Peter Elsner
- Klinik für Hautkrankheiten; Universitätsklinikum Jena
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Gina M, Ofenloch R, Diepgen TL, Elsner P. Quality of expert medical opinions on occupational skin cancer caused by natural UV light. J Dtsch Dermatol Ges 2017; 15:1244-1247. [DOI: 10.1111/ddg.13371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Michal Gina
- Department of Dermatology and Allergology; University Hospital Jena; Germany
| | - Robert Ofenloch
- Department of Clinical Social Medicine; Heidelberg University Medical Center; Germany
| | - Thomas Ludwig Diepgen
- Department of Clinical Social Medicine; Heidelberg University Medical Center; Germany
| | - Peter Elsner
- Department of Dermatology and Allergology; University Hospital Jena; Germany
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Hunter H, Mellerio J, Frew J, Warren R, Ofenloch R. News and Notices. Br J Dermatol 2017. [DOI: 10.1111/bjd.15851] [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: 11/30/2022]
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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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Brans R, Skudlik C, Weisshaar E, Scheidt R, Ofenloch R, Elsner P, Wulfhorst B, Schönfeld M, John SM, Diepgen TL. Multicentre cohort study ‘Rehabilitation of Occupational Skin Diseases - Optimization and Quality Assurance of Inpatient Management (ROQ)’: results from a 3-year follow-up. Contact Dermatitis 2016; 75:205-12. [DOI: 10.1111/cod.12614] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre; Trauma Hospital; 21033 Hamburg Germany
| | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre; Trauma Hospital; 21033 Hamburg Germany
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University of Heidelberg; 69115 Heidelberg Germany
| | - Reginald Scheidt
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University of Heidelberg; 69115 Heidelberg Germany
| | - Robert Ofenloch
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University of Heidelberg; 69115 Heidelberg Germany
| | - Peter Elsner
- Department of Dermatology; University Hospital Jena; 07743 Jena Germany
- Statutory Accident Insurance Clinic of Occupational Diseases; 08233 Falkenstein Germany
| | - Britta Wulfhorst
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre; Trauma Hospital; 21033 Hamburg Germany
| | - Michael Schönfeld
- Clinic for Occupational Diseases of the VBG (Statutory Accident Insurance); 83435 Bad Reichenhall Germany
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre; Trauma Hospital; 21033 Hamburg Germany
| | - Thomas L. Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University of Heidelberg; 69115 Heidelberg Germany
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Diepgen TL, Naldi L, Bruze M, Cazzaniga S, Schuttelaar ML, Elsner P, Goncalo M, Ofenloch R, Svensson Å. Prevalence of Contact Allergy to p-Phenylenediamine in the European General Population. J Invest Dermatol 2016; 136:409-415. [PMID: 26802237 DOI: 10.1016/j.jid.2015.10.064] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/27/2015] [Accepted: 09/18/2015] [Indexed: 11/29/2022]
Abstract
Population-based studies on contact allergy to p-phenylenediamine (PPD) are scarce. A cross-sectional study was performed to assess the prevalence of contact allergy to PPD and its risk factors in the general population of 5 European countries. A total of 10,425 subjects were interviewed, and a random sample (n = 2,739) was patch tested to PPD. Overall, 5,286 individuals (50.9%) reported having used hair colorants at least once in their lifetime (78% female, 20% male), and 35% had used hair colorants during the last 12 months. Hair colorant avoidance because of any skin problem during the lifetime was reported by 6%. Black henna tattoos had been used by 5.5% during their lifetime. The prevalence of PPD contact allergy was 0.8% (95% confidence interval 0.6-1.0%), with no statistically significant association with gender or hair dye use. The prevalence of PPD in black henna tattoo users was 3.2% versus 0.6% in nonusers (P < 0.001). A clinically relevant positive patch test reaction to PPD related to hair coloring products was found in 0.1% (95% confidence interval 0.0-0.2%). A significant association with PPD contact allergy was observed for subjects who had black henna tattoos in their lifetime, with an age- and gender-adjusted odds ratio of 9.33 (95% confidence interval 3.45-25.26, P < 0.001). Black henna tattoos are an important risk factor for PPD contact allergy.
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Affiliation(s)
- Thomas L Diepgen
- Department of Social Medicine, Occupational and Environmental Dermatology, University Heidelberg, Heidelberg, Germany.
| | - Luigi Naldi
- Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Centro Studi GISED-FROM Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Simone Cazzaniga
- Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Centro Studi GISED-FROM Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - Marie-Louise Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Margarida Goncalo
- Department of Dermatology, Coimbra University Hospital, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Robert Ofenloch
- Department of Social Medicine, Occupational and Environmental Dermatology, University Heidelberg, Heidelberg, Germany
| | - Åke Svensson
- Department of Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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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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Mirembe SK, Mulyowa GK, Jaeger G, Ofenloch R, Diepgen TL, Weisshaar E. Hand Eczema in Africa: Clinical Findings and Experiences from South-West Uganda. Acta Derm Venereol 2016; 96:388-9. [PMID: 26390834 DOI: 10.2340/00015555-2246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Stephen K Mirembe
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, Ruprecht Karls University, University Hospital Heidelberg, DE-69115 Heidelberg, Germany
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Heinl D, Prinsen CAC, Drucker AM, Ofenloch R, Humphreys R, Sach T, Flohr C, Apfelbacher C. Measurement properties of quality of life measurement instruments for infants, children and adolescents with eczema: protocol for a systematic review. Syst Rev 2016; 5:25. [PMID: 26860189 PMCID: PMC4748496 DOI: 10.1186/s13643-016-0202-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 02/02/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Eczema is a common chronic or chronically relapsing, inflammatory skin disease that exerts a substantial negative impact on quality of life (QoL). The Harmonising Outcome Measures for Eczema (HOME) initiative has used a consensus-based process which identified QoL as one of the four core outcome domains to be assessed in all eczema clinical trials. A number of measurement instruments exist to measure QoL in infants, children, and adolescents with eczema, and there is a great variability in both content and quality of the instruments used. Therefore, the objective of the proposed research is to comprehensively and systematically assess the measurement properties of the existing measurement instruments that were developed and/or validated for the measurement of patient-reported QoL in infants, children, and adolescents with eczema. METHODS/DESIGN This study is a systematic review of the measurement properties of patient-reported measures of QoL developed and/or validated for infants, children, and adolescents with eczema. A systematic literature search will be carried out in MEDLINE via PubMed and EMBASE using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing, or comparing measurement properties of QoL instruments for infants, children, and adolescents with eczema. Two reviewers will independently perform eligibility assessment and data abstraction. Evidence tables will be used to record study characteristics, instrument characteristics, measurement properties, and interpretability. The adequacy of the measurement properties will be assessed using predefined criteria. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist will be used to evaluate the methodological quality of included studies. A best evidence synthesis will be undertaken if more than one study has examined a particular measurement property. DISCUSSION The proposed systematic review will yield a comprehensive assessment of measurement properties of existing QoL instruments in infants, children, and adolescents with eczema. The results will serve as a basis to recommend a QoL measurement instrument for infants, one for children, and one for adolescents for use in future clinical trials. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015023483.
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Affiliation(s)
- Daniel Heinl
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
| | - Cecilia A C Prinsen
- Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Aaron M Drucker
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Robert Ofenloch
- Department of Clinical Social Medicine, University Hospital Heidelberg, Heidelberg, Germany.
| | | | - Tracey Sach
- Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Carsten Flohr
- St John's Institute of Dermatology, King's College London, London, UK.
| | - Christian 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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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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Apfelbacher CJ, Heinl D, Prinsen CAC, Deckert S, Chalmers J, Ofenloch R, Humphreys R, Sach T, Chamlin S, Schmitt J. Measurement properties of adult quality-of-life measurement instruments for eczema: protocol for a systematic review. Syst Rev 2015; 4:48. [PMID: 25927828 PMCID: PMC4403900 DOI: 10.1186/s13643-015-0041-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/02/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Eczema is a common chronic or chronically relapsing skin disease that has a substantial impact on quality of life (QoL). By means of a consensus-based process, the Harmonising Outcome Measures in Eczema (HOME) initiative has identified QoL as one of the four core outcome domains to be assessed in all eczema trials (Allergy 67(9):1111-7, 2012). Various measurement instruments exist to measure QoL in adults with eczema, but there is a great variability in both content and quality (for example, reliability and validity) of the instruments used, and it is not always clear if the best instrument is being used. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the measurement properties of the existing measurement instruments that were developed and/or validated for the measurement of patient-reported QoL in adults with eczema. METHODS/DESIGN This study is a systematic review of the measurement properties of patient-reported measures of QoL developed and/or validated for adults with eczema. Medline via PubMed and EMBASE will be searched using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing, or comparing measurement properties of QoL instruments for adult patients with eczema. Eligibility assessment and data abstraction will be performed independently by two reviewers. Evidence tables will be generated for study characteristics, instrument characteristics, measurement properties, and interpretability. The quality of the measurement properties will be assessed using predefined criteria. Methodological quality of studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis will be undertaken if more than one study has investigated a particular measurement property. DISCUSSION The proposed systematic review will produce a comprehensive assessment of measurement properties of existing QoL instruments in adult patients with eczema. We aim to identify one best currently available instrument to measure QoL in eczema patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015017138.
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Affiliation(s)
- Christian J Apfelbacher
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, 93051, Regensburg, Germany. .,Division of Public Health and Primary Care, Brighton and Sussex Medical School, Falmer, BN1 9PH, UK.
| | - Daniel Heinl
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, 93051, Regensburg, Germany.
| | - Cecilia A C Prinsen
- Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, 1081 BT, Amsterdam, The Netherlands.
| | - Stefanie Deckert
- Centre for Evidence-based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU Dresden, 01307, Dresden, Germany.
| | - Joanne Chalmers
- Centre of Evidence Based Dermatology, The University of Nottingham, Nottingham, NG7 2NR, UK.
| | - Robert Ofenloch
- Department of Clinical Social Medicine, University Hospital Heidelberg, 69115, Heidelberg, Germany.
| | | | - Tracey Sach
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
| | - Sarah Chamlin
- Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
| | - Jochen Schmitt
- Centre for Evidence-based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU Dresden, 01307, Dresden, Germany.
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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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Naldi L, Cazzaniga S, Gonçalo M, Diepgen T, Bruze M, Elsner P, Coenraads PJ, Svensson Å, Bertuccio P, Ofenloch R. Prevalence of Self-reported Skin Complaints and Avoidance of Common Daily Life Consumer Products in Selected European Regions. JAMA Dermatol 2014; 150:154-63. [DOI: 10.1001/jamadermatol.2013.7932] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Luigi Naldi
- Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Centro Studi Gruppo Italiano Studi Epidemiologici in Dermatologia–Fondazione per la Ricerca Ospedale Maggiore Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - Simone Cazzaniga
- Centro Studi Gruppo Italiano Studi Epidemiologici in Dermatologia–Fondazione per la Ricerca Ospedale Maggiore Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Thomas Diepgen
- Department of Social Medicine, University Heidelberg, Heidelberg, Germany5Department of Occupational and Environmental Dermatology, University Heidelberg, Heidelberg, Germany
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, University Hospital, Lund University, Malmö, Sweden
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Peter J. Coenraads
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Åke Svensson
- Department of Dermatology, Institute of Clinical Research in Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Paola Bertuccio
- Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Scientific Institute for Research, Hospitalization, and Health Care, Milan, Italy
| | - Robert Ofenloch
- Department of Social Medicine, University Heidelberg, Heidelberg, Germany
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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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Weisshaar E, Büttner M, Ofenloch R, Matterne U. Do patients with chronic pruritus benefit from a specialized itch clinic? A patient survey. Acta Derm Venereol 2012; 92:553-4. [PMID: 22002589 DOI: 10.2340/00015555-1212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Matterne U, Apfelbacher CJ, Loerbroks A, Schwarzer T, Büttner M, Ofenloch R, Diepgen TL, Weisshaar E. Prevalence, correlates and characteristics of chronic pruritus: a population-based cross-sectional study. Acta Derm Venereol 2012. [PMID: 21879245 DOI: 10.2340/00015555-1159.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pruritus is the most frequent symptom in dermatology. Its impact on quality of life is substantial. Epidemiological data on chronic pruritus (>6 weeks) at the population level is sparse, but is important in order to understand the burden and risk factors of this distressing symptom. The aim of this population-based cross-sectional study was to estimate the point, 12-month and lifetime prevalence of chronic pruritus, assessing its association with sociodemographic variables and describing its characteristics. A validated postal questionnaire was sent to 4,500 individuals in from the German General population. Three contact attempts were made. The response rate was 57.8% (n=2,540). The point prevalence of chronic pruritus was 13.5% (95% confidence interval (95% CI) 12.2-14.9%), 12-month prevalence 16.4% (15.0-17.9%) and lifetime prevalence 22.0% (20.4-23.7%). Multivariate analyses found only ethnic origin independently associated with chronic pruritus. The impact of chronic pruritus on quality of life and emotional well-being appears to depend on severity rather than on the presence of the symptom alone. This is the first study to investigate various prevalence estimates of chronic pruritus at the population level. Despite its limitations (self-report and potential self-selection) this study indicates a high burden of chronic pruritus in society.
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Affiliation(s)
- Uwe Matterne
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Thibautstr. 3, DE-69115 Heidelberg, Germany.
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Matterne U, Apfelbacher CJ, Loerbroks A, Schwarzer T, Büttner M, Ofenloch R, Diepgen TL, Weisshaar E. Prevalence, correlates and characteristics of chronic pruritus: a population-based cross-sectional study. Acta Derm Venereol 2011; 91:674-9. [PMID: 21879245 DOI: 10.2340/00015555-1159] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pruritus is the most frequent symptom in dermatology. Its impact on quality of life is substantial. Epidemiological data on chronic pruritus (>6 weeks) at the population level is sparse, but is important in order to understand the burden and risk factors of this distressing symptom. The aim of this population-based cross-sectional study was to estimate the point, 12-month and lifetime prevalence of chronic pruritus, assessing its association with sociodemographic variables and describing its characteristics. A validated postal questionnaire was sent to 4,500 individuals in from the German General population. Three contact attempts were made. The response rate was 57.8% (n=2,540). The point prevalence of chronic pruritus was 13.5% (95% confidence interval (95% CI) 12.2-14.9%), 12-month prevalence 16.4% (15.0-17.9%) and lifetime prevalence 22.0% (20.4-23.7%). Multivariate analyses found only ethnic origin independently associated with chronic pruritus. The impact of chronic pruritus on quality of life and emotional well-being appears to depend on severity rather than on the presence of the symptom alone. This is the first study to investigate various prevalence estimates of chronic pruritus at the population level. Despite its limitations (self-report and potential self-selection) this study indicates a high burden of chronic pruritus in society.
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Affiliation(s)
- Uwe Matterne
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Thibautstr. 3, DE-69115 Heidelberg, Germany.
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