Systemic therapy and the use of complementary and alternative medicine in patients with recognized occupational hand eczema in Denmark: A cross‐sectional questionnaire‐based study

Abstract

Background: Concerns have been raised that a chronic course of hand eczema (HE) could be fostered by a lack of efficient treatment at an early stage.Objectives: First, to assess the prevalence of systemic treatment in patients with chronic occupational HE (OHE) and relate this to demographic data, HE severity, and atopic dermatitis (AD). Second, to explore the use of complementary and alternative medicine (CAM) in the same population.Methods: Baseline data were obtained from a registry-based study including patients with recognized OHE in a 2-year period in Denmark, comprising a total of 2703 workers. A follow-up questionnaire after 4 to 5 years included questions on disease severity and treatments.Results: A total of 1565 participants responded to the questionnaire, and of these 1203 had ongoing HE at follow-up and were included in the study. In total, 10.0% had received systemic therapy, whereas this share was 13.3% in those with selfreported moderate-to-severe HE. Age >35 years, previous or current AD, and severe eczema were factors related to use of systemic treatment. Use of CAM was reported by 6.2% of the study population. Conclusions:We suggest that chronicity of HE may be perpetuated by the lack of efficient treatment. K E Y W O R D S chronic eczema, hand eczema, occupational hand eczema, systemic treatment, treatment of hand eczema, wet work

The pan‐JAK inhibitor delgocitinib in a cream formulation demonstrates dose response in chronic hand eczema in a 16‐week randomized phase IIb trial*

“…Alitretinoin treatment may require medical and laboratory monitoring, and a pregnancy prevention programme for women of child‐bearing age/potential 16 . Due to the limitations of current treatment options, CHE disease management remains difficult and unsatisfactory 2,4,5,16–20 . Consequently, safe and effective treatment options specifically developed for long‐term control of CHE across subtypes are needed 17 …”

The management of Chronic Hand Eczema: A retrospective patient record review

“…An earlier survey of dermatology clinics in Germany that included 223 patients reported systemic therapy use in 11.7% 18 . Similarly, a survey of 1203 patients with occupational CHE in Denmark reported that 10% had received systemic therapy, increasing to 13.3% in those with self‐reported moderate to severe disease 19 . Age >35 years, previous or current atopic dermatitis, and severe eczema were factors related to use of systemic treatment.…”

“…18 Similarly, a survey of 1203 patients with occupational CHE in Denmark reported that 10% had received systemic therapy, increasing to 13.3% in those with self-reported moderate to severe disease. 19 Sex (female/male/non-binary), n, (%) 395 (49.9)/396 (50.0)/1 (0. hyperkeratotic hand eczema, whereas oral corticosteroids were identified as the most frequent first-line treatment for vesicular hand eczema. 20 Our data show that over 60% of patients with moderate to severe CHE received systemic therapy, with almost one-quarter received biologic therapy.…”

What do professional cleaners know about the skin care? A questionnaire‐based study

“…Hand eczema (HE) (or dermatitis) is an inflammatory skin disease located to the hands, wrists or lower forearms with a 1‐year prevalence of at least 9.1% in the general population 1 . Risk factors related to a poor prognosis are wet work, higher age, lower socio‐economic status, and a history of atopic dermatitis (AD) 2–4 . HE can become chronic and is associated with decreased quality‐of‐life (QoL) and distress 1,5 .…”