BACKGROUND: Hand eczema (HE) is a frequent, long-lasting disease with both personal and societal repercussions. Consequently, more information is needed on factors that maintain symptoms. OBJECTIVES: In this study, patients with HE were followed for 6 months from the first visit to a dermatologist to identify factors associated with severe disease and a poor prognosis. METHODS: Study participants were 799 patients with HE from nine dermatological clinics in Denmark. Severity assessment of the HE was done at baseline and at the 6-month follow-up using the Hand Eczema Severity Index (HECSI) and by patients using a self-administered photographic guide. Additional information was obtained from a baseline questionnaire. RESULTS: At baseline, 60.3% assessed their HE as moderate to very severe using the self-administered photographic guide compared with 36.1% at follow-up. The mean HECSI value decreased from 19.9 points at baseline to 11.2 points at follow-up (P or = 1 positive patch test (P
BACKGROUND: Population-based studies on the incidence of hand eczema are sparse. OBJECTIVES: The aim of this prospective follow-up study was to determine the incidence rate of hand eczema in a population-based twin cohort. Secondly, the role of genetic factors and other potential risk factors for hand eczema was investigated. METHODS: A questionnaire on self-reported hand eczema was answered by 5610 and 4128 twin individuals in 1996 and 2005, respectively. Data were analysed in a Poisson regression analysis. RESULTS: The crude incidence rate was 8.8 cases per 1000 person-years (95% confidence interval, [CI] 7.7-9.9). Incidence rate ratios (IRRs) dependent on the co-twin's hand eczema status revealed a significant, doubled risk for monozygotic twin individuals with a co-twin affected by hand eczema, compared with dizygotic twin individuals with a co-twin affected by hand eczema (IRR 2.4, 95% CI 1.4-4.1). Also, significantly increased IRRs were found for positive patch test, atopic dermatitis, and wet work. CONCLUSIONS: Hand eczema is still a frequent disease and genetic factors are confirmed important risk factors. Positive patch test, atopic dermatitis and wet work were associated with an increased risk, whereas no association with age, sex, smoking or alcohol was found.
BACKGROUND: Staphylococcus aureus in atopic skin has been associated with exacerbation of eczema. Objectives To investigate a possible association between neonatal colonization with S. aureus and the risk of atopic dermatitis (AD) during the first 3 years of life. MATERIALS AND METHODS: The study participants were 356 children born of mothers with asthma from the Copenhagen Prospective Study on Asthma in Childhood. Swabs from the vestibulum nasi and the perineum were cultured at 1 month and 1 year, from acute eczema, and from parents (vestibulum nasi and pharynx). AD development and severity were monitored prospectively. RESULTS: Of the neonates, 5.3% had positive swabs for S. aureus cultured from the vestibulum nasi (51.3%) and/or the perineum (11.3%). Forty-two per cent developed AD, but without association between colonization with S. aureus at 1 month of age and risk of developing AD at 3 years of age. There was a 70% concordance for S. aureus carriage between neonates and parents. At 1 year of age 11.3% children had swabs positive for S. aureus. Fourteen per cent of children tested at the 1-year visit developed AD after the visit but before 3 years of age, but again, there was no association between colonization with S. aureus and the risk of AD. In children seen at acute visits the severity of AD measured by scoring of atopic dermatitis (SCORAD) was significantly higher in children with a positive culture for S. aureus in lesions. CONCLUSIONS: Colonization with S. aureus at 1 month of age is not associated with an increased risk of developing AD during the first 3 years of life.
BACKGROUND: Previous studies show that use of complementary and alternative medicine (CAM) is frequent among dermatological patients in general and that the use of CAM is linked to disease severity and duration. OBJECTIVES: To investigate factors influencing the use of CAM and visits to alternative practitioners among patients with allergic contact dermatitis. METHODS: The study was a postal questionnaire survey among 485 patients with allergic contact dermatitis to fragrances and preservatives in consumer products. The questionnaire included questions about use of conventional treatment, use of CAM and visits to alternative therapists. It also included questions about eczema severity and duration as well as social factors. The patients were recruited from one dermatological clinic in the capital city area and two clinics in smaller cities. RESULTS: The response rate was 79%. Forty per cent of respondents were users of CAM, predominantly in combination with conventional treatment, and 29% had visited an alternative practitioner. Women were found to be significantly more frequent users of CAM and visitors to alternative practitioners than men, and patients from urban/rural districts reported more frequent use of CAM than patients from the capital city area. Frequent eczema eruptions, hand eczema, long duration of disease and work-related problems were positively associated with use of CAM and/or visits to alternative practitioners. CONCLUSIONS: The typical CAM user is female, lives in a rural district or town (not the capital area), has long disease duration and often work-related problems. Overall, the use of CAM is not an alternative to conventional treatment, but is a supplement.