Hand eczema - prognosis and consequences: a 7 year follow-up study

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 seven 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.

METHODS: In all, 536 patients with hand eczema examined by a dermatologist were participating. The clinical severity was assessed at baseline and seven 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 seven 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. This article is protected by copyright. All rights reserved.