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Jeanne D. Johansen - One of the best experts on this subject based on the ideXlab platform.
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increased occurrence of Hand Eczema in young children following the danish Hand hygiene recommendations during the covid 19 pandemic
Contact Dermatitis, 2021Co-Authors: Anne Birgitte Simonsen, Jacob P. Thyssen, Jeanne D. Johansen, Iben F Ruge, Anna S Quaade, Claus ZachariaeAbstract:Background During the first wave of the COVID-19 pandemic of Spring 2020, Denmark was one of the first countries to introduce lockdown measures, including closing of all daycare centers. Following the reopening of daycare centers, Danish Health Authorities implemented a mandatory intensive Hand hygiene regimen. Objectives To examine the occurrence and point prevalence of Hand Eczema as a consequence of more intensive Hand hygiene among Danish children attending daycare. Methods The heads of 1,667 daycare centers in Denmark were contacted and asked to forward a link to a questionnaire to parents of the children attending the daycare center. Results Among 6858 children, 12.1% suffered from Hand Eczema before reopening of daycare centers, whereas 38.3% reported Hand Eczema after the children returned to daycare. Of the children who never suffered from Hand Eczema, 28.6% developed Hand Eczema after returning to daycare. The risk of Hand Eczema was significantly associated with atopic dermatitis, female gender, higher age, and frequency of Handwashing. Conclusion Following the implemented hygiene regimen, a high proportion of young children rapidly developed Hand Eczema. Well-established prophylactic skin care might have spared a proportion of the children from developing Hand Eczema. This article is protected by copyright. All rights reserved.
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Hand Eczema atopic dermatitis and filaggrin mutations in adult danes a registry based study assessing risk of disability pension
Contact Dermatitis, 2017Co-Authors: Nina G Heede, Allan Linneberg, Jacob P. Thyssen, Torkil Menné, Betina H Thuesen, Pal B Szecsi, Steen Stender, Jeanne D. JohansenAbstract:SummaryBackground Atopic dermatitis and Hand Eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss-of-function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences. Objective To investigate the personal consequences of having atopic dermatitis and/or Hand Eczema and FLG mutations. Method Adult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or Hand Eczema (n = 496) were genotyped for common FLG mutations, and completed a questionnaire about skin symptoms and Hand Eczema. Socioeconomic variables, including disability pension, and information on work in risk occupations were retrieved from national registries. The reasons for granting disability pension were unknown. Results Disability pension was associated with Hand Eczema in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self-reported Hand Eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1.15–14.11; and OR 6.01 and 95%CI: 2.37–15.34, respectively]. Furthermore, 60% of the FLG mutation carriers with atopic dermatitis who developed Hand Eczema had experienced symptoms before adulthood. Conclusion In the general population, self-reported Hand Eczema and atopic dermatitis, particularly in individuals with a genetically impaired skin barrier, were associated with disability pension, suggesting that FLG mutations carriers with a history of atopic dermatitis and Hand Eczema could benefit from early attention with respect to choice of occupation.
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predictive factors of self reported Hand Eczema in adult danes a population based cohort study with 5 year follow up
British Journal of Dermatology, 2016Co-Authors: Nina G Heede, Allan Linneberg, Jacob P. Thyssen, Betina H Thuesen, Jeanne D. JohansenAbstract:BACKGROUND Information about predictive factors of Hand Eczema is crucial for primary prevention. OBJECTIVES To investigate predictive factors of Hand Eczema in adult Danes from the general population. METHODS Participants from a cross-sectional 5-year follow-up study in the general population, aged 18-72 years (n = 2270), completed questionnaires about skin health and were grouped into four Hand Eczema groups: 'never', 'incident', 'nonpersistent' and 'persistent'. Multiple logistic regression models adjusted for age group and sex were used to evaluate associations with baseline variables. The participation rate for the follow-up study was 66·5% (29·7% of the participants originally invited to the baseline study). RESULTS A history of atopic dermatitis (AD) was associated with both persistent and incident Hand Eczema [odds ratio (OR) 9·0, 95% confidence interval (95% CI) 5·6-14·4 and OR 3·0, 95% CI 1·7-5·2, respectively]. Thus, even in adulthood, a history of AD should be considered as a predictor of incident Hand Eczema. While filaggrin gene (FLG) null mutations were not associated with incident Hand Eczema, a statistically significant association was observed with persistent Hand Eczema (OR 3·1, 95% CI 1·8-5·2). Finally, contact sensitization (23 allergens without nickel) was also associated with persistent Hand Eczema (OR 2·5, 95% CI 1·2-5·0), independently of a history of AD. CONCLUSIONS This study confirms a history of AD as the strongest predictor of persistent Hand Eczema. We additionally found that a history of AD was associated with incident Hand Eczema in adults, in contrast to FLG mutations, which were associated only with persistent Hand Eczema in individuals with a history of AD, and not with incident Hand Eczema. Our study adds new knowledge to the interplay between AD, FLG mutations and Hand Eczema in the adult general population.
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Hand Eczema prognosis and consequences a 7 year follow up study
British Journal of Dermatology, 2014Co-Authors: A H Petersen, Jeanne D. Johansen, Marianne HaldAbstract:Summary Background Hand Eczema is recognized as a long-lasting disease with personal and societal repercussions. Long-term studies are required to generate information on factors contributing to a poor outcome. Objectives The aims of this 7-year follow-up study were to evaluate the clinical course of patients with Hand Eczema, the occupational consequences and to identify risk factors associated with a poor prognosis. Materials and methods In all, 536 patients with Hand Eczema participated and were examined by a dermatologist. The clinical severity was assessed at baseline and 7 years later using a self-administrated photographic guide. Additional information was obtained from a questionnaire. Results Based on the photographic guide, 73% experienced a clinical improvement. Notably, 20% had moderate to very severe Hand Eczema at follow-up. Severe Hand Eczema or frequent eruptions at baseline and Eczema in other body locations during the follow-up period were risk factors of a poor prognosis. The same factors, as well as being a woman, were associated with occupational consequences and low health-related quality of life. Of those with persistent Hand Eczema only 40% had visited a dermatologist during the follow-up period and 7% had oral treatment. Conclusions The disease had improved 7 years later; nevertheless, many patients continued to have considerable symptoms. Patients with a greater risk of a poor outcome are characterized by frequent eruptions, severe Hand Eczema and more widespread Eczema. It should be questioned if more aggressive therapy and closer medical follow-up would be beneficial.
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knowledge attitudes and behaviour in everyday life with chronic Hand Eczema a qualitative study
British Journal of Dermatology, 2013Co-Authors: Annette Mollerup, Jeanne D. Johansen, Lone Friis ThingAbstract:Summary Background Chronic Hand Eczema is a common disease that may impact quality of life and have occupational and social consequences. Self-management is pivotal, both in Handling acute eruptions and avoiding relapses. However, little is known about how people with Hand Eczema self-manage and integrate their disease into everyday life. Objectives To explore the knowledge, attitudes and everyday life behaviours of patients with chronic Hand Eczema in order to generate insights about barriers in self-management. Methods Qualitative, semistructured, focus group interviews were carried out. Twenty-three people with Hand Eczema participated in the four group sessions. The content of the interviews was analysed according to a template of concepts, categories and codes. Results Patients felt they lacked knowledge about the causes of Eczema and how best to manage it. They perceived it as a complex condition, yet only simple solutions were offered. The patients found it difficult to apply preventive strategies in everyday life. They wanted to take an active role in their course of illness, but experienced barriers such as discomfort from emollient treatment or feelings of stigmatization. The patients stated that the need to focus constantly on prevention was energy-consuming. Conclusion Self-management support in chronic Hand Eczema needs to be individualized in order to provide specific knowledge relevant to the patient, so that the patient has realistic expectations concerning the course of disease and can adopt new habits that minimize effort in preventive behaviour.
Tove Agner - One of the best experts on this subject based on the ideXlab platform.
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Hand Eczema treatment
Journal of The European Academy of Dermatology and Venereology, 2020Co-Authors: P Elsner, Tove AgnerAbstract:Hand Eczema is a highly prevalent, multietiological disease with a wide spectrum of severity and chronicity. The treatment of Hand Eczema, especially in severe and chronic cases, is a challenge to the dermatologist requiring not only diagnostic and therapeutic, but also excellent patient communication skills. This review discusses the spectrum of therapeutic options for Hand Eczema, the evidence for their efficacy and safety, and proposes a stepwise approach of intensity of treatment depending on disease severity and chronicity. In the near future, Hand Eczema patients may benefit from new therapeutic principles such as biologics for the treatment of atopic Eczema and topical Janus Kinase inhibitors.
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factors influencing prognosis for occupational Hand Eczema new trends
British Journal of Dermatology, 2019Co-Authors: Caroline Meyer Olesen, Tove Agner, N E Ebbehoj, Tanja K CaroeAbstract:BACKGROUND Variables traditionally reported to influence the prognosis of occupational Hand Eczema (OHE) are atopic dermatitis (AD) and contact sensitization. However, recent studies indicate that lifestyle factors may be of major importance. OBJECTIVES To identify factors influencing the prognosis in a cohort of patients with recognized OHE. METHODS In this register-based cohort study, individuals with Hand Eczema recognized as occupational disease in the period January 2010-December 2011 were identified using files from Labor Market Insurance Denmark and included in the study. At baseline, information on sex, age, occupation, wet work, AD and contact sensitization was collected. In 2015 participants received a questionnaire with questions about lifestyle factors, current occupation and healing of OHE. RESULTS In total, 2703 patients received the questionnaire; 1491 responded to the question about healing of OHE and were included in the study. Altogether, 19·3% of patients reported complete healing at follow-up. Current tobacco smoking and a high level of stress were factors inversely associated with healing of Hand Eczema (P < 0·001 and P = 0·030, respectively), while a high level of exercise was significantly related to healing of Eczema (P = 0·011). Change of profession was a favourable prognostic factor, while age, sex, AD, contact sensitization and education did not significantly influence prognosis. CONCLUSIONS Traditionally important risk factors such as AD and contact sensitization had no marked influence on prognosis, while lifestyle factors were of major importance. Our findings indicate that risk factors may vary over time, allowing for new perspectives on prevention. What's already known about this topic? Occupational Hand Eczema has a relapsing course and a poor overall prognosis. Atopic dermatitis and contact sensitization have previously been reported as risk factors for a poor prognosis. What does this study add? The results indicate that lifestyle factors are of importance for the prognosis of occupational Hand Eczema. Traditionally reported risk factors such as atopic dermatitis and contact sensitization do not currently influence prognosis.
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Hand Eczema and wet work dose response relationship and effect of leaving the profession
Contact Dermatitis, 2018Co-Authors: Tanja K Caroe, Niels E Ebbehoj, Jens Peter Bonde, Esben Meulengracht Flachs, Tove AgnerAbstract:BACKGROUND Wet work is an important risk factor for occupational Hand Eczema. OBJECTIVES To examine the effect of job change in workers with occupational Hand Eczema caused by wet work, and to evaluate the dose-response relationship between intensity of wet work and Eczema. METHOD The study is based on a subgroup (n = 954) from a descriptive, registry-based study including all participants with occupational Hand Eczema caused by wet work recognized by the Danish Labour Market Insurance Authority in 2010 and 2011. A follow-up questionnaire was sent out 4-5 years later (response 58%). RESULTS Change of profession and being outside the labour market had a positive effect on healing and improvement of Hand Eczema. Inverse dose-response relationships were found between the amount of time spent with wet Hands at work and healing (p = 0.001) and improvement (p < 0.001), and between the frequency of Hand washing at work and healing (p = 0.013) and improvement (p < 0.001). CONCLUSIONS Leaving the profession has a positive effect on Eczema; however, even minor changes in exposure to wet work were associated with healing and improvement. This information has implications with respect to advice given to patients with occupational Hand Eczema caused by wet work.
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occupational Hand Eczema and or contact urticaria factors associated with change of profession or not remaining in the workforce
Contact Dermatitis, 2018Co-Authors: Tanja K Caroe, Niels E Ebbehoj, Jens Peter Bonde, Tove AgnerAbstract:SummaryBackground Occupational Hand Eczema and/or contact urticaria may have social consequences such as change of profession or not remaining in the workforce. Objectives To identify factors associated with job change in a cohort of participants with recognised occupational Hand Eczema/contact urticaria Methods A registry-based study including 2703 employees with recognised occupational Hand Eczema/contact urticaria in Denmark in 2010/2011. Four to five years later the participants received a follow-up questionnaire, comprising questions on current job situation (response rate 58.0%). Results At follow-up, 51.3% of the participants were no longer in the same profession. 32.5% had changed profession and 18.8% were no longer in employment. Change of profession was associated with young age, positive patch test, low educational level and severity of Hand Eczema/contact urticaria. With regard to specific professions, cleaning personnel changed profession significantly more often than other workers [71.4% (OR = 2.26)], health care workers significantly less often than other workers [34.0% (OR = 0.36)]. Conclusion Job change occurs frequently during the first years after recognition of occupational Hand Eczema/contact urticaria and more often among patients with positive patch test reactions, with severe Hand Eczema/contact urticaria. Whether job changes improve the prognosis of occupational Hand Eczema/contact urticaria remains to be established.
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comparison of four methods for assessment of severity of Hand Eczema
Contact Dermatitis, 2013Co-Authors: Tove Agner, Pieter-jan Coenraads, Jacob Mutanu Jungersted, Thomas L. DiepgenAbstract:Background Several instruments for the assessment of the severity of Hand Eczema and health-related quality of life (HR-QoL) related to Hand Eczema have been developed. Objectives The aim of the present study was to evaluate the correlation between frequently used methods. Methods Consecutive patients with current Hand Eczema from three different centres participated in the study. Severity of Hand Eczema was assessed with the Hand Eczema Severity Index (HECSI), the Physician Global Assessment (PGA), the Clinical Photo Guide, and the Dermatology Life Quality Index (DLQI). Results One hundred and nineteen patients with Hand Eczema were included in the study. All six pairwise correlation coefficients between the tested methods were highly statistically significant. Correlation was highest between the HECSI and the PGA (r = 0.82), and weakest, although still statistically significant, between the DLQI and the other three severity scores (r between 0.30 and 0.45). Age and frequency of eruptions did not influence the correlations. With respect to sex, there was a tendency for correlation between methods to be higher for men than for women. Conclusion We found an overall positive correlation between the four severity assessments applied. As the weakest correlation was found between the DLQI and the other methods, it is suggested that measurement of HR-QoL should be included for assessment of the severity and consequences of Hand Eczema, but the finding also indicates that a disease-specific tool for evaluation of HR-QoL in Hand Eczema patients is needed.
Torkil Menné - One of the best experts on this subject based on the ideXlab platform.
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Hand Eczema atopic dermatitis and filaggrin mutations in adult danes a registry based study assessing risk of disability pension
Contact Dermatitis, 2017Co-Authors: Nina G Heede, Allan Linneberg, Jacob P. Thyssen, Torkil Menné, Betina H Thuesen, Pal B Szecsi, Steen Stender, Jeanne D. JohansenAbstract:SummaryBackground Atopic dermatitis and Hand Eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss-of-function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences. Objective To investigate the personal consequences of having atopic dermatitis and/or Hand Eczema and FLG mutations. Method Adult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or Hand Eczema (n = 496) were genotyped for common FLG mutations, and completed a questionnaire about skin symptoms and Hand Eczema. Socioeconomic variables, including disability pension, and information on work in risk occupations were retrieved from national registries. The reasons for granting disability pension were unknown. Results Disability pension was associated with Hand Eczema in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self-reported Hand Eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1.15–14.11; and OR 6.01 and 95%CI: 2.37–15.34, respectively]. Furthermore, 60% of the FLG mutation carriers with atopic dermatitis who developed Hand Eczema had experienced symptoms before adulthood. Conclusion In the general population, self-reported Hand Eczema and atopic dermatitis, particularly in individuals with a genetically impaired skin barrier, were associated with disability pension, suggesting that FLG mutations carriers with a history of atopic dermatitis and Hand Eczema could benefit from early attention with respect to choice of occupation.
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prevention of Hand Eczema among danish hairdressing apprentices an intervention study
Chemical Hazards in Industry, 2012Co-Authors: Anne Bregnhoj, Torkil Menné, Jeanne D. Johansen, Heidi SostedAbstract:To investigate whether an evidence-based intervention could reduce the incidence of Hand Eczema in a cohort of Danish hairdressing apprentices during their training, as hairdressing apprentices are known to have a high risk of developing Hand Eczema. This study was a clinically controlled, prospective intervention study. Within 2 weeks of starting their training, 502 hairdressing apprentices were enrolled in the study on occupational Hand Eczema. Approximately half of the apprentices were assigned to an intervention group and received an evidence-based training program developed for this study and delivered by teachers specially trained in the prevention of Hand Eczema; the other half received normal training and served as a control group. All apprentices completed self-administered questionnaires including questions regarding Hand Eczema, use of gloves and degree of wet work, and were all clinically examined for Hand Eczema three times during the 18-month study period. The three examinations were scheduled as school visits and consisted of a baseline examination and two follow-up examinations approximately 8 and 18 months later. More apprentices from the intervention group used gloves during wet work procedures and significantly fewer developed Hand Eczema compared with apprentices from the control group (p=0.04). A logistic regression model showed that atopic dermatitis had a significant influence on the development of Hand Eczema in the cohort irrespective of the intervention. The authors were able to increase the use of gloves and reduce the incidence of Hand Eczema in hairdressing apprentices by implementing a training program in hairdressing schools.
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prevention of Hand Eczema among danish hairdressing apprentices an intervention study
Occupational and Environmental Medicine, 2012Co-Authors: Anne Bregnhoj, Torkil Menné, Jeanne D. Johansen, Heidi SostedAbstract:Objectives To investigate whether an evidence-based intervention could reduce the incidence of Hand Eczema in a cohort of Danish hairdressing apprentices during their training, as hairdressing apprentices are known to have a high risk of developing Hand Eczema. Methods This study was a clinically controlled, prospective intervention study. Within 2 weeks of starting their training, 502 hairdressing apprentices were enrolled in the study on occupational Hand Eczema. Approximately half of the apprentices were assigned to an intervention group and received an evidence-based training program developed for this study and delivered by teachers specially trained in the prevention of Hand Eczema; the other half received normal training and served as a control group. All apprentices completed self-administered questionnaires including questions regarding Hand Eczema, use of gloves and degree of wet work, and were all clinically examined for Hand Eczema three times during the 18-month study period. The three examinations were scheduled as school visits and consisted of a baseline examination and two follow-up examinations approximately 8 and 18 months later. Results More apprentices from the intervention group used gloves during wet work procedures and significantly fewer developed Hand Eczema compared with apprentices from the control group (p=0.04). A logistic regression model showed that atopic dermatitis had a significant influence on the development of Hand Eczema in the cohort irrespective of the intervention. Conclusions We were able to increase the use of gloves and reduce the incidence of Hand Eczema in hairdressing apprentices by implementing a training program in hairdressing schools.
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validation of self reporting of Hand Eczema among danish hairdressing apprentices
Contact Dermatitis, 2011Co-Authors: Anne Bregnhoj, Torkil Menné, Heidi Sosted, Jeanne D. JohansenAbstract:Background. Hairdressing apprentices have a high incidence of Hand Eczema. Most studies use self-reported Hand Eczema as a cost-effective method to estimate the prevalence of Hand Eczema. No validation studies on self-reported Hand Eczema among hairdressing apprentices exist. Objectives. To evaluate the validity of self-reporting of Hand Eczema among Danish hairdressing apprentices. Methods. During their first 2 weeks of training, 502 hairdressing apprentices were enrolled in this study. All apprentices completed a self-administered questionnaire including questions regarding, for example, current Hand Eczema, and they were all clinically examined for Hand Eczema three times during the first part of their education by use of the Hand Eczema Severity Index. The validity of self-reporting of Hand Eczema was measured with the clinical examination as the gold standard. Results. The sensitivity of self-reporting of Hand Eczema was 70.3%, and the specificity was 99.8%. The positive predictive value was 96.3%, and the negative predictive value was 98.5%. Conclusions. We found good agreement between self-reporting of Hand Eczema and clinical examination. There was good sensitivity and high specificity. Self-reporting of Hand Eczema among hairdressing apprentices is considered to be a valid method for estimating the prevalence of Hand Eczema, although it might underestimate the true prevalence.
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Hand Eczema guidelines based on the danish guidelines for the diagnosis and treatment of Hand Eczema
Contact Dermatitis, 2011Co-Authors: Torkil Menné, Mette Sommerlund, Jeanne D. Johansen, Niels K. VeienAbstract:BACKGROUND: Classification of Hand Eczema has traditionally been based both on aetiology and clinical appearance. For 20% of cases, the aetiology is unknown. OBJECTIVES: To suggest a classification based on well-defined aetiology as well as on predefined clinical patterns and on the dynamics of Hand Eczema. METHODS: Literature studies and discussions among members of the Danish Contact Dermatitis Group. RESULTS: Criteria are given for the aetiological diagnoses of allergic contact dermatitis of the Hands, irritant contact dermatitis of the Hands, protein contact dermatitis of the Hands, atopic Hand Eczema and aetiologically unclassifiable Hand Eczema. Six different clinical patterns are described and illustrated. Suggestions for general treatment principles are given. CONCLUSION: Operational guidelines for the diagnosis and treatment of Hand Eczema are described.
B Meding - One of the best experts on this subject based on the ideXlab platform.
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scoring of Hand Eczema good reliability of Hand Eczema extent score
Acta Dermato-venereologica, 2017Co-Authors: Annica Carlsson, B Meding, Ake Svensson, Christopher D Anderson, Irina Baranovskaya, Monica Hindsenstenstrom, Ingebjorg Holt, Berndt Stenberg, Hans Stenlund, Agneta GanemoAbstract:There is good agreement between dermatological staff and patients using the Hand Eczema Extent Score (HEES). The aim of this study was to assess inter- and intra-observer reliability of the HEES in ...
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Hand Eczema and atopic dermatitis in adolescents a prospective cohort study from the bamse project
British Journal of Dermatology, 2015Co-Authors: Carina M Gronhagen, Carola Liden, Carlfredrik Wahlgren, Natalia Ballardini, Anna Bergstrom, Inger Kull, B MedingAbstract:Summary Background There is a well-known association between atopic dermatitis (AD) and Hand Eczema but less is known about how age at onset, persistence and severity of AD influence the risk of developing Hand Eczema. Objectives To examine the role of AD in the occurrence of Hand Eczema in adolescence. In addition, associations between asthma and rhinoconjunctivitis, sensitization to common airborne and food allergens, and Hand Eczema were studied. Methods From the population-based birth cohort BAMSE, 2927 adolescents who had been followed up repeatedly concerning allergy-related disease were included. Questionnaires identified adolescents with Hand Eczema at 16 years, and their blood was analysed for specific IgE. Results A total of 152 (5·2%) adolescents had Hand Eczema at the age of 16 years. Many of these adolescents had a history of AD (n = 111; 73·0%) and asthma and/or rhinitis (n = 83; 54·6%), respectively. Children with AD (aged 0–16 years) had more than threefold increased odds ratios (OR) for having Hand Eczema; those with persistent or severe AD had a crude OR of 6·1 [95% confidence interval (CI) 4·0–9·1] and 5·3 (95% CI 2·9–9·6), respectively. Conclusions We confirm a strong association between AD during childhood and Hand Eczema in adolescence. Children with persistent or more severe AD are at greater risk of developing Hand Eczema. Asthma and/or rhinoconjunctivitis, positive specific IgE or age at onset of AD are not associated with Hand Eczema in adolescence.
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life style factors and Hand Eczema
British Journal of Dermatology, 2011Co-Authors: Anveden I Berglind, Magnus Alderling, B MedingAbstract:Summary Background Previous knowledge of the impact of certain life-style factors on Hand Eczema is scanty. Objectives To investigate a possible association between Hand Eczema and life-style factors such as obesity, physical exercise, stress, smoking and alcohol consumption. Methods In a cross-sectional public health survey in Stockholm, Sweden, 27 994 (58%) randomly chosen individuals aged 18–64 years completed a postal questionnaire regarding physical and mental health, social relations, economic status and work. Of these, 27 793 individuals responded to the question regarding Hand Eczema and were included in the present study. The association between life-style factors and Hand Eczema was analysed by prevalence proportion ratios (PPR), using a generalized linear model. Results Hand Eczema was more common among individuals who reported high stress levels, PPR 1·326 (95% CI 1·303–1·350). There was also a positive dose–response relationship between Hand Eczema and stress. Hand Eczema was less common among individuals reporting high physical exercise, and most apparent in women, PPR 0·781 (95% CI 0·770–0·792). Men who reported high alcohol intake reported Hand Eczema less often, PPR 0·958 (95% CI 0·930–0·987). Obese individuals reported Hand Eczema more commonly, PPR 1·204 (95% CI 1·174–1·234). There was a slight increase of Hand Eczema among smokers, PPR 1·025 (95% CI 1·006–1·044). Conclusions Hand Eczema was more common in individuals who reported stress, obesity and smoking. In individuals who reported high physical exercise levels Hand Eczema was less common. As there appears to be an association between life-style factors and Hand Eczema it is important to consider life-style factors in clinical practice.
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Hand Eczema and quality of life a population based study
British Journal of Dermatology, 2009Co-Authors: Cecilia Moberg, Magnus Alderling, B MedingAbstract:Summary Background Hand Eczema is a common disease in the population and is of interest from a public health perspective. Health-related quality of life (HRQoL) is increasingly being measured in dermatology. Objectives To investigate HRQoL in relation to Hand Eczema in the general population. Methods In the Public Health Survey of Stockholm County Council 2006, a questionnaire was sent to 57 009 randomly selected individuals aged 18–84 years. The response rate among persons of working age (18–64 years) was 58%. The questionnaire included a validated question concerning Hand Eczema and a generic instrument for measurement of HRQoL, the EQ-5D. Results The proportion of individuals reporting problems was significantly larger among those with than without Hand Eczema in all five dimensions of the EQ-5D. Gender differences were found in some age subgroups. The EQ-5D index was lower for individuals with Hand Eczema than for those without, and on the same level as for psoriasis and asthma. Beta regression showed that the strongest confounding factors were low back pain, depression and hay fever/asthma. Conclusions HRQoL was negatively affected in individuals with Hand Eczema irrespective of age. With the EQ-5D instrument it is also possible to detect certain gender differences. The EQ-5D index for Hand Eczema was of the same size as for psoriasis and asthma, all common diseases with an impact on public health. It is of importance to acknowledge the influence of Hand Eczema on daily life, in order to give the patients good care.
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incidence of Hand Eczema in female swedish hairdressers
Occupational and Environmental Medicine, 2007Co-Authors: Marielouisel Lind, Maria Albin, Jonas Brisman, Kerstin Kronholm Diab, Linnea Lillienberg, Zoli Mikoczy, Jorn Nielsen, Lars Rylander, Kjell Toren, B MedingAbstract:Objective: To estimate the occurrence of Hand Eczema in hairdressers in Sweden. Methods: The occurrence of Hand Eczema was estimated in a Swedish longitudinal retrospective cohort study including all female graduates from vocational schools for hairdressers from 1970 to 1995. A stratified sample from the general population acted as controls. A self-administered questionnaire including questions on the occurrence of Hand Eczema, skin atopy, working periods and number of hair treatments performed per week was sent to the participants. Incidence rate ratios (IRRs) of Hand Eczema were estimated. Results: The incidence rate of Hand Eczema in hairdressers was 23.8 cases/1000 person-years, whereas in hairdressers who were aged Conclusion: Hairdressers are highly exposed to skin-damaging substances. The self-reported incidence of Hand Eczema was substantially higher in female hairdressers than in controls from the general population and than that found previously in register-based studies. For many individuals, onset of Hand Eczema occurs early in life. Only about 10% of the Hand Eczema cases among hairdressers would be prevented if no one with skin atopy entered the trade.
Thomas L. Diepgen - One of the best experts on this subject based on the ideXlab platform.
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cross cultural validation of the quality of life in Hand Eczema questionnaire qolheq
Journal of Investigative Dermatology, 2017Co-Authors: Robert Ofenloch, Marielouise Schuttelaar, Jart A. F. Oosterhaven, Ake Svensson, Paivikki Susitaival, Elke Weisshaar, Keiko Minamoto, Meltem Onder, Emel Bulbul Baskan, Thomas L. DiepgenAbstract:The Quality of Life in Hand Eczema Questionnaire (QOLHEQ) is the only instrument assessing disease-specific health-related quality of life in patients with Hand Eczema. It is available in eight language versions. In this study we assessed if the items of different language versions of the QOLHEQ yield comparable values across countries. An international multicenter study was conducted with participating centers in Finland, Germany, Japan, The Netherlands, Sweden, and Turkey. Methods of item response theory were applied to each subscale to assess differential item functioning for items among countries. Overall, 662 Hand Eczema patients were recruited into the study. Single items were removed or split according to the item response theory model by country to resolve differential item functioning. After this adjustment, none of the four subscales of the QOLHEQ showed significant misfit to the item response theory model (P < 0.01), and a Person Separation Index of greater than 0.7 showed good internal consistency for each subscale. By adapting the scoring of the QOLHEQ using the methods of item response theory, it was possible to obtain QOLHEQ values that are comparable across countries. Cross-cultural variations in the interpretation of single items were resolved. The QOLHEQ is now ready to be used in international studies assessing the health-related quality of life impact of Hand Eczema.
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cost of illness analysis of patients with chronic Hand Eczema in routine care in germany focus on the impact of occupational disease
Acta Dermato-venereologica, 2013Co-Authors: Thomas L. Diepgen, Swen Malte John, S Purwins, J Posthumus, Daniel Kuessner, Matthias AugustinAbstract:Chronic Hand Eczema places a heavy burden on patients, often affecting their ability to work. This paper compares the cost-of-illness and treatment approaches for patients with refractory chronic Hand Eczema, in relation to whether the disease was occupational or unrelated to work factors. Data from 2 surveys, comprising 310 patients with chronic Hand Eczema insured by German statutory health insurance (SHI) (including work-impaired patients, work-unaffected patients and non-working patients) and known work-related chronic Hand Eczema insured by occupational health insurance (OHI). Annual healthcare costs of managing work-impaired patients (SHI) and patients with work-related chronic Hand Eczema (OHI) were €3,164 and €3,309, respectively, approximately double the costs of managing non-working and work-unaffected (SHI) patients. This analysis shows that the costs associated with chronic Hand Eczema are affected by the correlation of chronic Hand Eczema with work, with costs being higher for occupational patients with chronic Hand Eczema.
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cost of illness from occupational Hand Eczema in germany
Contact Dermatitis, 2013Co-Authors: Thomas L. Diepgen, Swen Malte John, Reginald Scheidt, Elke Weisshaar, Klaus HiekeAbstract:SummaryBackground There is little knowledge about the costs of occupational Hand Eczema. Objectives To estimate the societal costs of patients with occupational Hand Eczema in Germany. Methods Resource use during the past year, disease severity and quality of life [Dermatology Life Quality Index (DLQI)] were gathered for patients with occupational Hand Eczema before they entered a special rehabilitation programme. Costs were calculated from the societal perspective. The analysis focused on all patients and the severity groups no signs/mild (group A) and moderate to severe (group B). Results One hundred and fifty-one patients were analysed, with a mean age of 44.9~years and a mean DLQI score of 10.9; 64.9% were male. Sickness absence was recorded for 62.9% of all patients (76.4~days on average in the last 12~months). Annual societal costs were €8799 per patient. Indirect costs represented 70% of total costs. Quality of life (DLQI) was statistically different across both severity groups (group A, 7.9; group B, 12.9), but direct treatment costs were not (€2705 versus €2610, respectively). There was a trend towards higher indirect costs in patients in severity group B (group A, €5120; group B, €6796). Conclusion The annual societal costs of patients with occupational Hand Eczema in this study are high, and similar to those for severe psoriasis and atopic dermatitis.
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comparison of four methods for assessment of severity of Hand Eczema
Contact Dermatitis, 2013Co-Authors: Tove Agner, Pieter-jan Coenraads, Jacob Mutanu Jungersted, Thomas L. DiepgenAbstract:Background Several instruments for the assessment of the severity of Hand Eczema and health-related quality of life (HR-QoL) related to Hand Eczema have been developed. Objectives The aim of the present study was to evaluate the correlation between frequently used methods. Methods Consecutive patients with current Hand Eczema from three different centres participated in the study. Severity of Hand Eczema was assessed with the Hand Eczema Severity Index (HECSI), the Physician Global Assessment (PGA), the Clinical Photo Guide, and the Dermatology Life Quality Index (DLQI). Results One hundred and nineteen patients with Hand Eczema were included in the study. All six pairwise correlation coefficients between the tested methods were highly statistically significant. Correlation was highest between the HECSI and the PGA (r = 0.82), and weakest, although still statistically significant, between the DLQI and the other three severity scores (r between 0.30 and 0.45). Age and frequency of eruptions did not influence the correlations. With respect to sex, there was a tendency for correlation between methods to be higher for men than for women. Conclusion We found an overall positive correlation between the four severity assessments applied. As the weakest correlation was found between the DLQI and the other methods, it is suggested that measurement of HR-QoL should be included for assessment of the severity and consequences of Hand Eczema, but the finding also indicates that a disease-specific tool for evaluation of HR-QoL in Hand Eczema patients is needed.
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anxiety depression and impaired health related quality of life in patients with occupational Hand Eczema
Contact Dermatitis, 2012Co-Authors: Dana Boehm, Swen Malte John, Thomas L. Diepgen, Gerhard Schmidott, Florence Finkeldey, Christine Dwinger, Thomas Werfel, Kristine BreuerAbstract:Background. Occupational Hand Eczema is one of the most frequent occupational diseases. Few data about the prevalence of mental comorbidities are available. Objectives. We aimed to investigate the prevalence of anxiety, depression symptoms, the impairment of health-related quality of life (HRQoL) and their correlates in patients with occupational Hand Eczema. Patients and methods. A test battery consisting of the German versions of the Hospital Anxiety and Depression Scale, the Dermatology Life Quality Index (DLQI) as a specific instrument and the Short Form Health Survey-36 (SF-36) as a generic instrument for HRQoL was applied in 122 patients. The severity of Hand Eczema was assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). Results. Twenty per cent of patients had a positive anxiety score, and 14% had a positive depression score. Higher anxiety levels, a greater impairment in the SF-36 mental component summary score and a higher DLQI category score for symptoms and feelings was detected in females than in males. The OHSI correlated with the impairment in HRQoL, and an association of severe Hand Eczema with symptoms of anxiety and depression was found in males. Conclusions. We found a high prevalence of anxiety and depression in our study population of patients with occupational Hand Eczema. Preventive measures should consider the psychosocial implications of occupational Hand Eczema.
