Hand eczema: causes, course, and prognosis II

Abstract

Objective-To determine the clinical course of diabetes mellitus in tropical Africa. Design-Continuing care and follow up until 31 March 1989 of all newly diagnosed diabetic patients registered at one hospital between 1 June 1981 and 31 May 1987. Setting-Muhimbili Medical Centre, Dar es Salaam, Tanzania. Subjects-1250 Newly diagnosed diabetic patients seen over a six year period. 272 (21-8%) Had diabetes requiring insulin, 825 (66.0%) diabetes not requiring insulin, and 153 (12-2%) diatetes of uncertain type. Main outcome measures-Survival rates during each year of follow up. Results-205 (16.4%) Patients were known to have died, 126 (61-5%) in hospital and 79 (38-5%) in the community. At least a further 71 patients were likely to have died. The five year survival rates (95% confidence intervals) for patients with diabetes requiring and not requiring insulin were 71% (62% to 80%) and 84% (80% to 89%) respectively for known deaths and 60% (51% to 69%) and 82% (77% to 86%) respectively for known plus probable deaths. 49 (3-9%) Patients died at the time of presentation. Severe diabetic ketoacidosis and infection were responsible for most deaths in patients with diabetes requiring insulin. Infection was responsible for 24% of deaths in patients with diabetes not requiring insulin and was the main cause of death in the group with uncertain type of diabetes. Cardiovascular and renal causes were responsible for 24% of hospital deaths of patients with diabetes not requiring insulin. Diabetes requiring insulin, young age, and ketonuria at presentation were associated with a significantly worse five year survival on multivariate analysis. On univariate analysis underweight, female sex, low educational background, and manual occupations were additional factors with a worse prognosis.

Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema

“…Contact reactions to proteins are typically of an urticarial type, and last from 0.5 to 2 hr. Characteristic symptoms among persons who react to foodstuffs are burning, stinging, and itching, seconds to minutes after contact with the foodstuff in question (13). Eczema may develop on repeated exposure.…”

Diagnosing chronic hand eczema by an algorithm: a tool for classification in clinical practice

“…The clinical diagnosis of CHE refers to an aetiologically heterogeneous disease group, but its terminology lacked a generally accepted taxonomy. Diagnosis was based on aetiology when possible and morphology when necessary 3–6 . Recently, Diepgen et al.…”

Quality of Life, Use of Topical Medications and Socio-economic Data in Hand Eczema: A Swedish Nationwide Survey

“…Variations in prevalence with geographical area (north, middle and south of Sweden) have been reported (1). The long-term prognosis for HE is poor (7,8) and it has been reported that, in 5% of cases, HE had farreaching consequences for the individual (7). The long-term prognosis for HE is poor (7,8) and it has been reported that, in 5% of cases, HE had farreaching consequences for the individual (7).…”