TY - JOUR
T1 - Chronic Hand Eczema Guidelines From an Expert Panel of the International Eczema Council
AU - Silverberg, Jonathan I
AU - Guttman-Yassky, Emma
AU - Agner, Tove
AU - Bissonnette, Robert
AU - Cohen, David E
AU - Simpson, Eric
AU - Wollenberg, Andreas
AU - Thyssen, Jacob P
N1 - Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Contact Dermatitis Society.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: Assessment of chronic hand eczema (CHE) is complex and warrants standardization.OBJECTIVE: We sought to guide clinicians on the assessment of CHE.METHODS: An electronic questionnaire regarding the diagnosis and assessment of CHE was completed by councilors (n=45) of the International Eczema Council, an international group of clinicians and researchers with expertise in CHE. The survey consisted of 52 statements for consensus.RESULTS: Overall, nine statements (17.3%) had strong, twenty-three (44.2%) moderate, 12 (23.1%) low, and 8 (15.4%) very low levels of agreement. Five statements had considerable disagreement, including the value of conducting a skin biopsy (62.2% disagreement), investigating for possible type 1 reactions (60.0%), conducting a fungal culture (44.4%), finding no history of relevant allergens and/or irritants (31.1%) in most or all cases, and performing patch testing irrespective of lesion location and morphology (28.9%). Agreement was generally highest among respondents from Europe (28.6-77.8% agreement), followed by Asia (7.1%-35.7% agreement), North America (0%-35.5% agreement), and other (0%-13.3% agreement).CONCLUSIONS: There were substantial differences of agreement, suggesting there are many knowledge and/or practice gaps with respect to CHE. Future research is needed to inform evidence-based and/or consensus guidelines for CHE.
AB - BACKGROUND: Assessment of chronic hand eczema (CHE) is complex and warrants standardization.OBJECTIVE: We sought to guide clinicians on the assessment of CHE.METHODS: An electronic questionnaire regarding the diagnosis and assessment of CHE was completed by councilors (n=45) of the International Eczema Council, an international group of clinicians and researchers with expertise in CHE. The survey consisted of 52 statements for consensus.RESULTS: Overall, nine statements (17.3%) had strong, twenty-three (44.2%) moderate, 12 (23.1%) low, and 8 (15.4%) very low levels of agreement. Five statements had considerable disagreement, including the value of conducting a skin biopsy (62.2% disagreement), investigating for possible type 1 reactions (60.0%), conducting a fungal culture (44.4%), finding no history of relevant allergens and/or irritants (31.1%) in most or all cases, and performing patch testing irrespective of lesion location and morphology (28.9%). Agreement was generally highest among respondents from Europe (28.6-77.8% agreement), followed by Asia (7.1%-35.7% agreement), North America (0%-35.5% agreement), and other (0%-13.3% agreement).CONCLUSIONS: There were substantial differences of agreement, suggesting there are many knowledge and/or practice gaps with respect to CHE. Future research is needed to inform evidence-based and/or consensus guidelines for CHE.
UR - http://www.scopus.com/inward/record.url?scp=85102604025&partnerID=8YFLogxK
U2 - 10.1097/DER.0000000000000659
DO - 10.1097/DER.0000000000000659
M3 - Journal article
C2 - 32991335
SN - 1710-3568
VL - 32
SP - 319
EP - 326
JO - Dermatitis
JF - Dermatitis
IS - 5
ER -