Hand eczema treatment: Change behaviour with text messaging, a randomized trial

Abstract

Background: Irritant contact dermatitis is the most common type of hand eczema.Effective treatment usually involves avoidance of irritants and use of appropriate topical medication. In this study, the effectiveness of using text messaging addressing preventive behaviours and appropriate medication adherence was evaluated. Methods: Patients who were admitted to Istanbul Training and Research HospitalDermatology Department March 1, 2015 to July 31, 2015, and diagnosed with hand eczema were enrolled. Patients were randomly divided into the SMS group and the non-SMS group. Text messages were sent to the mobile phones of the patients in the SMS group. Severity of hand eczema, compliance to treatment, patients' information level, adherence to preventive behaviours, and the protective behaviour score were evaluated at baseline, and at the 4th and 8th week.Results: Eighty-one patients with hand eczema were included in the study. After 8 weeks, the decrease in the Hand Eczema Severity Index score was 70.2% (SD 35.2) in the SMS group and 38.9% (SD 67.7) in the non-SMS group (P = .017). Sending SMS to patients increased the use of moisturizer. There was no statistically significant difference in other behaviours.Conclusion: This study demonstrated that text messaging improves the treatment success and specifically the frequency of moisturizer use in patients with hand eczema.

A mixed methods systematic review of digital interventions to support the psychological health and well-being of people living with dermatological conditions

“…Several studies indicated a diagnosis by a clinician as a requirement for inclusion ( 43 , 50 , 57 ). Other studies specified people with a ‘diagnosis’ as an inclusion criterion but failed to clarify whether this was a self- or clinician-diagnosis ( 40 , 45 – 47 , 51 , 55 , 56 , 58 – 61 ). However, given that research participants were mostly recruited from outpatient dermatology clinics ( 40 – 42 , 44 – 46 , 54 , 55 , 61 , 62 ) or using a combination of recruitment methods ( 52 , 53 , 58 – 60 ), it is reasonable to assume that most studies included people with an established dermatological condition.…”

“…The three studies (41,45,46) that assessed knowledge all reported significant improvements. One study found a significant improvement (p = 0.007) in the average knowledge scores between intervention (11/14) and control (9/14) groups immediately post-intervention (46).…”

The Challenge of Hand Eczema: Pathogenesis, Treatment, and Burden of Disease

“…Probably, continuous encouragement by text messaging (for example SMS/whats app) could increase the use of topical and oral medication in future hand eczema care. 45 Chapter 7 confirmed that systemic treatments could reduce severity and, as a result, health-related quality of life, treatment satisfaction, and treatment adherence. This finding suggests that clinicians should probably intensify anti-inflammatory treatment sooner in cases of severe chronic hand eczema with its significant impact on HRQoL due, for example, to absenteeism and/or depression.…”

“…An independent association of FLG mutations and hand eczema has not been found. [44][45][46][47] Furthermore, independently of gene mutations, studies in atopic dermatitis showed lower expression levels of filaggrin, involurin, and loricrin due to proinflammatory cytokines as IL-4. 48,49 Both FLG mutations and decreased fillagrin expression were not found in the current study.…”

“…It can be difficult for clinicians to distinguish hyperkeratotic subtypes from palmar psoriasis, since histological findings have an overlap (among others: confluent parakeratosis, psoriasiform elongated rete ridges, clubbing and anastomosis of the rete ridges). [43][44][45][46] Chapter 2 evaluates the histopathology of hyperkeratotic hand eczema, and discusses immunofluorescent stainings of different keratins, epidermal barrier proteins and adhe- In addition, to further elucidate the pathogenesis of hyperkeratotic hand eczema, all patients were screened for variants in genes related to palmoplantar keratoderma.…”