Chronic hand eczema: A prevalent disease in the general population associated with reduced quality of life and poor overall health measures.
atopic dermatitis
contact allergy
epidemiology
hand eczema
prevalence
quality of life
Journal
Contact dermatitis
ISSN: 1600-0536
Titre abrégé: Contact Dermatitis
Pays: England
ID NLM: 7604950
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
10
08
2023
received:
09
06
2023
accepted:
11
08
2023
medline:
8
11
2023
pubmed:
28
8
2023
entrez:
27
8
2023
Statut:
ppublish
Résumé
The impact of hand eczema (HE) on Health-Related Quality of Life (HRQoL) has only been sparsely studied in a general population setting, and never by use of the disease specific Quality Of Life in Hand eczema Questionnaire (QOLHEQ). To examine the HRQoL of unselected individuals with HE using the QOLHEQ. Further, to provide prevalence estimates of severe and chronic HE (CHE), and to contrast overall health related outcomes between individuals with and without HE. In this nationwide, cross-sectional study a questionnaire covering questions on HE related outcomes, and overall health was sent to a random sample of 100 000 Danish adults via a secure digital mailbox, linked to their unique civil registration numbers. Data on demographic characteristics were retrieved from the civil registration system. Individuals reporting HE, further answered the QOLHEQ and other disease specific questions. The response rate was 42.7% (n = 42 691). Total estimates of lifetime, 1-year and point prevalences of HE were 24.4%, 13.3% and 5.8%. Of individuals reporting a 1-year prevalence, 35.1% reported moderate-severe disease and 82.6% CHE. Individuals with HE were more likely to report less good or poor overall health, and sick leave (any reason), compared to those without. In the 2176 (92.5%) with current HE who completed the QOLHEQ, median QOLHEQ scores corresponded to a moderate impairment of the symptoms and treatment and prevention domains and a slight impairment overall and for the emotions and functioning domains. Factors that were strongly associated with moderate to severe HRQoL impairment included severe, chronic and occupational HE as well as female sex. HE is highly prevalent, bears a considerable burden on society and significantly affects the lives of impacted individuals. Our findings indicate a necessity for targeted prevention aimed at high-risk groups, and support and treatment for those most affected.
Sections du résumé
BACKGROUND
BACKGROUND
The impact of hand eczema (HE) on Health-Related Quality of Life (HRQoL) has only been sparsely studied in a general population setting, and never by use of the disease specific Quality Of Life in Hand eczema Questionnaire (QOLHEQ).
OBJECTIVES
OBJECTIVE
To examine the HRQoL of unselected individuals with HE using the QOLHEQ. Further, to provide prevalence estimates of severe and chronic HE (CHE), and to contrast overall health related outcomes between individuals with and without HE.
METHODS
METHODS
In this nationwide, cross-sectional study a questionnaire covering questions on HE related outcomes, and overall health was sent to a random sample of 100 000 Danish adults via a secure digital mailbox, linked to their unique civil registration numbers. Data on demographic characteristics were retrieved from the civil registration system. Individuals reporting HE, further answered the QOLHEQ and other disease specific questions.
RESULTS
RESULTS
The response rate was 42.7% (n = 42 691). Total estimates of lifetime, 1-year and point prevalences of HE were 24.4%, 13.3% and 5.8%. Of individuals reporting a 1-year prevalence, 35.1% reported moderate-severe disease and 82.6% CHE. Individuals with HE were more likely to report less good or poor overall health, and sick leave (any reason), compared to those without. In the 2176 (92.5%) with current HE who completed the QOLHEQ, median QOLHEQ scores corresponded to a moderate impairment of the symptoms and treatment and prevention domains and a slight impairment overall and for the emotions and functioning domains. Factors that were strongly associated with moderate to severe HRQoL impairment included severe, chronic and occupational HE as well as female sex.
CONCLUSIONS
CONCLUSIONS
HE is highly prevalent, bears a considerable burden on society and significantly affects the lives of impacted individuals. Our findings indicate a necessity for targeted prevention aimed at high-risk groups, and support and treatment for those most affected.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
453-463Subventions
Organisme : Kongelig Hofbuntmager Aage Bangs Fond
Informations de copyright
© 2023 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.
Références
Quaade AS, Simonsen AB, Halling AS, Thyssen JP, Johansen JD. Prevalence, incidence, and severity of hand eczema in the general population-a systematic review and meta-analysis. Contact Dermatitis. 2021;84:361-374.
Agner T, Elsner P. Hand eczema: epidemiology, prognosis and prevention. J Eur Acad Dermatology Venereol. 2020;34:4-12.
Lindberg M, Bingefors K, Meding B, Berg M. Hand eczema and health-related quality of life; a comparison of EQ-5D and the dermatology life quality index (DLQI) in relation to the hand eczema extent score (HEES). Contact Dermatitis. 2013;69:138-143.
Agner T, Andersen KE, Brandao FM, et al. Contact sensitisation in hand eczema patients-relation to subdiagnosis, severity and quality of life: a multi-centre study. Contact Dermatitis. 2009;61:291-296.
Kamphuis E, Loman L, Han HL, et al. Experiences from daily practice of upadacitinib treatment on atopic dermatitis with a focus on hand eczema: results from the BioDay registry. Contact Dermatitis. 2023;351-62:351-362.
Voorberg AN, Romeijn GLE, Bruin-weller MSD, Marie LA, Schuttelaar MLA. The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis-52 week results from the Dutch BioDay registry. Contact Dermatitis. 2022;87:185-191.
Yüksel YT, Nørreslet LB, Flachs EM, Ebbehøj NE, Agner T. Hand eczema, wet work exposure, and quality of life in health care workers in Denmark during the COVID-19 pandemic. JAAD Int. 2022;7:86-94.
Wallenhammar LM, Nyfjäll M, Lindberg M, Meding B. Health-related quality of life and hand eczema-a comparison of two instruments, including factor analysis. J Invest Dermatol. 2004;122:1381-1389.
Nørreslet LB, Agner T, Sørensen JA, Ebbehøj NE, Bonde JP, Fisker MH. Impact of hand eczema on quality of life: metropolitan versus non-metropolitan areas. Contact Dermatitis. 2018;78:348-354.
Thyssen JP, Johansen JD, Linneberg A, Menné T. The epidemiology of hand eczema in the general population - prevalence and main findings. Contact Dermatitis. 2010;62:75-87.
Hald M, Berg ND, Elberling J, Johansen JD. Medical consultations in relation to severity of hand eczema in the general population. Br J Dermatol. 2008;158:773-777.
Meding B, Swanbeck G. Consequences of having hand eczema. Contact Dermatitis. 1990;23:6-14.
Moberg C, Alderling M, Meding B. Hand eczema and quality of life: a population-based study. Br J Dermatol. 2009;161:397-403.
Bingefors K, Lindberg M, Isacson D, et al. Quality of life, use of topical medications and socio-economic data in hand eczema: a Swedish nationwide survey. Acta Derm Venereol. 2011;91:452-458.
Ofenloch RF, Weisshaar E, Dumke AK, Molin S, Diepgen TL, Apfelbacher C. The quality of life in hand eczema questionnaire (QOLHEQ): validation of the German version of a new disease-specific measure of quality of life for patients with hand eczema. Br J Dermatol. 2014;171:304-312.
Koumaki D, Apfelbacher CJ, Ofenloch RF. Translation and validation of the quality of life in hand eczema questionnaire (QOLHEQ) in the Greek language. Contact Dermatitis. 2023;88:83-85.
Minamoto K, Diepgen TL, Sato K, et al. Quality of life in hand eczema questionnaire: validation of the Japanese version of a disease-specific measure of quality of life for hand eczema patients. J Dermatol. 2018;45:1301-1305.
Oosterhaven JAF, Ofenloch RF, Schuttelaar MLA. Validation of the Dutch quality of life in hand eczema questionnaire (QOLHEQ). Br J Dermatol. 2020;183:86-95.
Ofenloch RF, Oosterhaven JAFF, Susitaival P, et al. Cross-cultural validation of the quality of life in hand eczema questionnaire (QOLHEQ). J Invest Dermatol. 2017;137:1454-1460.
Digitaliseringsstyrelsen. Statistik om digital post [Internet]. https://digst.dk/it-loesninger/digital-post/om-loesningen/tal-og-statistik/
Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208.
Susitaival P, Flyvholm MA, Meding B, et al. Nordic occupational skin questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Dermatitis. 2003;49:70-76.
Meding B, Barregård L. Validity of self-reports of hand eczema. Contact Dermatitis. 2001;45:99-103.
Bregnhøj A, Søsted H, Menné T, et al. Validation of self-reporting of hand eczema among Danish hairdressing apprentices. Contact Dermatitis. 2011;65:146-150.
Yngveson M, Svensson Å, Isacsson Å. Evaluation of a self-reported questionnaire on hand dermatosis in secondary school children. Acta Derm Venereol. 1997;77:455-457.
Coenraads PJ, Van Der Walle H, Thestrup-Pedersen K, et al. Construction and validation of a photographic guide for assessing severity of chronic hand dermatitis. Br J Dermatol. 2005;152:296-301.
Diepgen TL, Andersen KE, Brandao FM, et al. Hand eczema classification: a cross-sectional, multicentre study of the aetiology and morphology of hand eczema. Br J Dermatol. 2009;160:353-358.
Silverberg JI, Patel N, Immaneni S, et al. Assessment of atopic dermatitis using self-report and caregiver report: a multicentre validation study. Br J Dermatol. 2015;173:1400-1404.
QOLHEQ website [Internet]. https://qolheq.dermis.net/content/home/index_eng.html
Oosterhaven JAF, Ofenloch RF, Schuttelaar MLA. Interpretability of the quality of life in hand eczema questionnaire. J Invest Dermatol. 2020;140:785-790.
Heede NG, Thyssen JP, Thuesen BH, Linneberg A, Johansen JD. Predictive factors of self-reported hand eczema in adult Danes: a population-based cohort study with 5-year follow-up. Br J Dermatol. 2016;175:287-295.
Lerbaek A, Kyvik KO, Mortensen J, Bryld LE, Menné T, Agner T. Heritability of hand eczema is not explained by comorbidity with atopic dermatitis. J Invest Dermatol. 2007;127:1632-1640.
Thyssen JP, Linneberg A, Menné T, Nielsen NH, Johansen JD. The association between hand eczema and nickel allergy has weakened among young women in the general population following the Danish nickel regulation: results from two cross-sectional studies. Contact Dermatitis. 2009;61:342-348.
Thyssen JP, Linneberg A, Menné T, Nielsen NH, Johansen JD. The effect of tobacco smoking and alcohol consumption on the prevalence of self-reported hand eczema: a cross-sectional population-based study. Br J Dermatol. 2010;162:619-626.
Nielsen NH, Linneberg A, Menné T, et al. The association between contact allergy and hand eczema in 2 cross-sectional surveys 8 years apart: the Copenhagen allergy study. Contact Dermatitis. 2002;47:71-77.
Voorberg AN, Loman L, Schuttelaar MLA. Prevalence and severity of hand eczema in the Dutch general population: a cross-sectional, questionnaire study within the lifelines cohort study. Acta Derm Venereol. 2022;102:1-6.
Quaade AS, Wang X, Sølberg JBK, et al. Circulating biomarkers are associated with disease severity of chronic hand eczema and atopic dermatitis. Br J Dermatol. 2023;1-6:114-124.
Voorberg AN, Kamphuis E, Christoffers WA, Schuttelaar MLA. Efficacy and safety of dupilumab in patients with severe chronic hand eczema with inadequate response or intolerance to alitretinoin: a randomized, double-blind, placebo-controlled phase IIb proof-of-concept study. Br J Dermatol. 2023;1-6.
Thyssen JP, Schuttelaar MLAA, Alfonso JH, et al. Guidelines for diagnosis, prevention, and treatment of hand eczema. Contact Dermatitis. 2022;86:357-378.
Jylhä M. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med. 2009;69:307-316.
Desalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality Prediction with a Single General Self-Rated Health Question. J Gen Intern Med. 2005;21:267-275.
Armstrong A, Hahn-Pedersen J, Bartlett C, Glanville J, Thyssen JP. Economic burden of chronic hand eczema: a review. Am J Clin Dermatol. 2022;23:287-300.
Ebert JF, Huibers L, Christensen B, Christensen MB. Paper-or web-based questionnaire invitations as a method for data collection: cross-sectional comparative study of differences in response rate, completeness of data, and financial cost. J Med Internet Res. 2018;20:1-13.
Folkhälsomyndigheten. Miljöhälsorapport 2017 [Internet]. 2017 https://www.folkhalsomyndigheten.se/contentassets/c44fcc5df7454b64bf2565454bbdf0e3/miljohalsorapport-2017-02096-2016-webb.pdf