Predictive factors of self-reported hand eczema in adult Danes: a population-based cohort study with 5-year follow-up

Abstract

SummaryBackground Information about predictive factors of hand eczema is crucial for primary prevention. Objectives To investigate predictive factors of hand eczema in adult Danes from the general population. Methods Participants from a cross-sectional 5-year follow-up study in the general population, aged 18-72 years (n = 2270), completed questionnaires about skin health and were grouped into four hand eczema groups: 'never', 'incident', 'nonpersistent' and 'persistent'. Multiple logistic regression models adjusted for age group and sex were used to evaluate associations with baseline variables. The participation rate for the follow-up study was 66Á5% (29Á7% of the participants originally invited to the baseline study). Results A history of atopic dermatitis (AD) was associated with both persistent and incident hand eczema [odds ratio (OR) 9Á0, 95% confidence interval (95% CI) 5Á6-14Á4 and OR 3Á0, 95% CI 1Á7-5Á2, respectively]. Thus, even in adulthood, a history of AD should be considered as a predictor of incident hand eczema. While filaggrin gene (FLG) null mutations were not associated with incident hand eczema, a statistically significant association was observed with persistent hand eczema (OR 3Á1, 95% CI 1Á8-5Á2). Finally, contact sensitization (23 allergens without nickel) was also associated with persistent hand eczema (OR 2Á5, 95% CI 1Á2-5Á0), independently of a history of AD. Conclusions This study confirms a history of AD as the strongest predictor of persistent hand eczema. We additionally found that a history of AD was associated with incident hand eczema in adults, in contrast to FLG mutations, which were associated only with persistent hand eczema in individuals with a history of AD, and not with incident hand eczema. Our study adds new knowledge to the interplay between AD, FLG mutations and hand eczema in the adult general population.

Self‐reported hand eczema among dental workers in Japan – a cross‐sectional study

“…A recent study in Swedish adolescents showed that moderate/severe atopic dermatitis was significantly associated with hand eczema (OR 3.0, 95%CI: 1.5–6.0), but the OR for mild atopic dermatitis was lower (OR 1.3) and not significant . In a recent Danish population‐based study of adults (n = 2227), a history of atopic dermatitis was associated with both persistent and incident hand eczema (OR 9.0, 95%CI: 5.6–14.4 and OR 3.0, 95%CI: 1.7–5.2, respectively) .…”

Hand eczema, atopic dermatitis and filaggrin mutations in adult Danes: a registry‐based study assessing risk of disability pension

“…In our study, the prevalence of atopic dermatitis in the general population was found to decrease with increasing age: 13.7% (18-40 years), 10.9% (41-55 years), and 7.5% (>56 years). It could therefore be hypothesized that more individuals who are prone to developing hand eczema will hence enter the workforce in the years to come, when the younger generations with more atopic dermatitis become older, as a history of atopic dermatitis is the most pronounced predictive factor for hand eczema (6,45,46). This encourages effective preventive measures and early detection of skin symptoms.…”

Compliance Difficulties in Atopic Children, Reflections from an Eczema School in Sweden

“…The examples above are cases typical for the patient group that tends to need help over a prolonged period of time. We know that of patients with atopic dermatitis the majority of the patients symptoms disappear in early teens [22,23] but for those with more severe atopic dermatitis many will have ongoing clinical symptoms also as adults [24][25][26] and it is important that clinical, social or cultural reasons for frequent relapses are considered.…”