Background Stress has been recently implicated as a contributing factor of hand eczema (HE) severity. However, published data are both rare and contradictory justifying the need of further research. The purpose of this study was to evaluate the relation between stress and HE severity. Methods This is a cross-sectional study enrolling all patients who have been attending the Dermato-allergology unit of Farhat Hached University Hospital of Sousse over a period of one year. The HE severity was assessed by the Osnabrück Hand Eczema Severity Index (OHSI). The stress level was assessed by the Perceived Stress Scale-10 (PSS-10) in its validated Arabic version. Results During the study period, 109 participants meeting the inclusion criteria were identified. The mean age was 40 ± 9.9 years with a sex-ratio of 0.8. Severe eczema was found in 76 participants (69.7%). A high level of perceived stress was found in 18.3% of cases. A statistically significant association was noted between HE severity and the high level of perceived stress (p=0.039, OR = 4.46, 95% CI [0.96–20.59]) and the number of dependent children ≥3 (p=0.0039, OR = 1.92, 95% CI [0.51–7.22]). Leisure activity was found to be a protective factor against HE severity (p=0.031, OR = 0.27, 95% CI [0.09–0.80]). Conclusion Although the link between the severity of eczema and atopy, wet work, and contact with irritants and allergens is well known, the relation remains questionable for other factors including stress.

Background. Allergic contact dermatitis (ACD) is a common chronic skin disease that generates considerable public-health and socioeconomic costs. This disease affects the quality of life and the occupational activity of patients. Aims. To assess the quality of life (QOL) of patients with ACD and study the impact of this disease on their work productivity. Methods. This is a cross-sectional study carried out from January 2012 to December 2014. All patients diagnosed with ACD in the Dermato-Allergology Unit of the Occupational Medicine Department at Farhat Hached University Hospital, in Sousse, were included. The impact of skin disease on the QOL of affected persons was assessed using the Dermatology Life Quality Index (DLQI). The work productivity was measured using the Work Productivity and Activity Impairment Allergic Specific questionnaire (WPAI: AS). Results. The study population consisted of 150 patients. The average score of DLQI was 6.5. Over the previous 7 days, absenteeism rate was 25.9 ± 15.3%, presenteeism rate was 50.2 ± 32%, overall work productivity loss was 29.6 ± 19.4%, and daily activity impairment was 50.4 ± 32.3%. The DLQI score was significantly associated with atopy (p = 0.03), relapses strictly greater than 10 (p = 0.02), presenteeism (p <10−3), overall work productivity loss (p = 0.01), and daily activity impairment (p = 0.03). Conclusion. The impact of ACD on QOL and occupational activity seems important and requires specific attention from the occupational physician.

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