Hand eczema: causes, course, and prognosis II

Background: Hand eczema is a common dermatosis, often with a chronic course. Objective: To follow a well-described cohort of patients with hand eczema for 5 years. Patients and Methods: 522 consecutive hand eczema patients (175 men and 347 women) seen in a private practice of dermatology were sent a questionnaire once a year for 5 years. Results: After 1 year, the response rate was 80% (417 of 522), and after 5 years, the rate was 68%. After 1 year, 81% of the 417 respondents reported that they still had persistent or intermittent hand eczema. After 5 years, this number was 65% (232 of 355). The larger the area involved at the initial examination, the poorer the prognosis. After 1 year, 48% of the patients felt that their hand eczema had improved, while 6.7% felt that it had worsened. 25% of those who responded stated that they never used gloves. Few patients could provide new information about the cause of the dermatitis during the 5-year follow-up. Conclusions: Hand eczema is a chronic dermatosis. Although treatment may improve hand eczema, it rarely clears completely. Evidence-based measures need to be developed for the long-term management of hand eczema.