Comparison of Oral Psoralen–UV-A With a Portable Tanning Unit at Home vs Hospital-Administered Bath Psoralen–UV-A in Patients With Chronic Hand Eczema

Coevorden, A. Marco van; Kamphof, Willeke G.; Sonderen, Eric van; Bruynzeel, Derk P.; Coenraads, Pieter‐Jan

doi:10.1001/archderm.140.12.1463

Cited by 41 publications

(33 citation statements)

References 17 publications

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“…The high drop‐out rate of 21% may be considered a potential source of bias. There was, however, no difference between the drop‐outs and the remaining participants with regard to physician‐rated severity score at T1 or change between T1 and T2 1 . Furthermore, the physician‐rated severity score was calculated by taking the mean score of the right and the left hand.…”

Section: Discussionmentioning

confidence: 99%

Assessment of severity of hand eczema: discrepancies between patient- and physician-rated scores

Coevorden

Sonderen

Bouma

et al. 2006

British Journal of Dermatology

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Summary Background In clinical practice or trials on hand eczema the severity of this disease can be ‘measured’ in different ways: by means of a physician‐rated clinical severity score, a patient‐rated clinical severity score or by an indicator of the burden of disease. We assume that the patient‐rated severity score corresponds more with the (change in) burden of disease than with the physician‐rated severity score. Objectives To demonstrate how physicians and patients differ in their assessment of the severity of hand eczema as seen in a physician‐rated severity score, patient‐rated severity score and a burden of disease questionnaire. Methods We used data from an open‐label randomized controlled trial which was set up in two university hospital dermatology departments in the Netherlands, specializing in hand eczema. One hundred and fifty‐eight patients with moderate to severe chronic hand eczema were included. The main outcome measures were the physician‐rated severity score, based on five visible aspects of hand eczema (desquamation, erythema, vesicles, infiltration, fissures), the patient‐rated severity score (a self‐rating scale), a burden of disease questionnaire (the Dermatology Life Quality Index, DLQI) and the correlations between these parameters, both at inclusion and over time. Results Only desquamation and infiltration were significantly correlated with patient‐rated severity score. Patient‐rated severity score correlated with seven of 10 DLQI items, but it did not correlate with the items regarding influence on clothes worn, impairment of sporting activities, and problems associated with treatment of the skin. The majority of patients showed improvement in all parameters after treatment. However, the improvement in patient‐rated severity score was not clearly correlated with changes in physician‐rated severity score. Except for DLQI item 1 (itch, soreness, pain, stinging), none of the changes in burden of disease was correlated with changes in patient‐rated severity score. For each DLQI item, change over time correlated weakly with decreases in several, but not all, components of the physician‐rated severity score. Conclusions Disease severity can be expressed by different scores; these scores are not clearly correlated, and measure different aspects. Patient satisfaction is not guaranteed when treatment is focused solely on the visible aspects of hand eczema. Instead, burden of disease has a greater impact.

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Section: Discussionmentioning

confidence: 99%

Assessment of severity of hand eczema: discrepancies between patient- and physician-rated scores

Coevorden

Sonderen

Bouma

et al. 2006

British Journal of Dermatology

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“…Even with NB‐UVB, which has been shown to be more effective than PUVA, complete clearance is seen in only 50% of patients with generalized eczema . For CHFE, PUVA therapy has not been shown to have long‐term effectiveness with multiple studies showing no difference between either NB‐UVB or PUVA in CHFE treatment …”

Section: Discussionmentioning

confidence: 99%

Use of 308 nm excimer laser for the treatment of chronic hand and foot eczema

et al. 2016

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“…Patients find it problematic to schedule regular visits within normal working hours and to travel to the facilities. PUVA with portable home-UVA devices [66] and phototherapy with portable UVB devices [67] have been described, but are not recommended as a general practice due to concerns that uncontrolled use may be associated with an increased risk of carcinogenicity [58].…”

Section: Uv Therapymentioning

confidence: 99%

Hand Dermatitis: A Review of Clinical Features, Prevention and Treatment

2015

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Hand dermatitis is a socially significant health problem. This review provides a discussion on the clinical features and patterns as well as the differential diagnosis of hand dermatitis, because these are essential for proper diagnosis in clinical practice. The morphology, however, is poorly related to the etiology in chronic cases. In all cases of chronic hand dermatitis, a full diagnostic examination should be undertaken and the etiology should be clarified and addressed in the treatment concept, instead of just moving directly from a morphological diagnosis to therapy. Preventive measures should be included in the treatment concept according to etiology. A stepwise approach for escalating therapy is advised, including basic topical therapy, topical corticosteroids, calcineurin inhibitors, as well as phototherapy and systemic therapy with corticosteroids, alitretinoin, cyclosporine, methotrexate, azathioprine, and others.

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Comparison of Oral Psoralen–UV-A With a Portable Tanning Unit at Home vs Hospital-Administered Bath Psoralen–UV-A in Patients With Chronic Hand Eczema

Cited by 41 publications

References 17 publications

Assessment of severity of hand eczema: discrepancies between patient- and physician-rated scores

Assessment of severity of hand eczema: discrepancies between patient- and physician-rated scores

Use of 308 nm excimer laser for the treatment of chronic hand and foot eczema

Hand Dermatitis: A Review of Clinical Features, Prevention and Treatment

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