The Efficacy to Prevent Irritant Hand Eczema: an Overview of the Interventional Procedures
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Contact Dermatitis (A Gimenez-Arnau, Section Editor)
The Efficacy to Prevent Irritant Hand Eczema: an Overview of the Interventional Procedures Mie Sonne, BSc.Med Tove Agner, MD, DMSc Line Brok Nørreslet, MD Tamara Theresia Lund, MD* Address * Department of Dermatology, Bispebjerg and Frederiksberg hospital, University of Copenhagen, Copenhagen, Denmark Email: [email protected]
* Springer Nature Switzerland AG 2020
This article is part of the Topical Collection on Contact Dermatitis Keywords Hand eczema I Irritant contact dermatitis I Hand eczema prevention I Occupational hand eczema I Patient education
Abstract Purpose of review Interventional procedures to prevent hand eczema (HE), comprising educational programs, are widely used for primary, secondary, and tertiary prevention of irritant contact dermatitis on the hands. This review gives an overview of randomized controlled trials (RCTs) addressing the efficacy of interventional procedures and educational programs in HE prevention. Recent findings RCTs on HE prevention differ with respect to form and implementation of interventions, populations, and follow-up times. Overall, the education has focused on use of moisturizers, gloves, and substitution of hand washes with alcohol-based hand rubs. Regarding outcome measures, the effect of interventions on prevalence (i.e., primary prevention) has been inconclusive. Meanwhile, educational programs aiming at HE patients (secondary prevention) had a positive effect on behavior in four out of five RCTs and a decrease in HE severity in four out of six RCTs (one with group-based and three with individual-based education). Positive effect on knowledge and on health-related quality of life was only found in few studies. Summary Overall, preventive educational programs are useful. Along with intensified, individual-based educations rather than group-based education, a shorter follow-up time seems to influence outcome measures positively. Future studies should investigate the long-term benefit from repeated educational sessions to maintain the positive benefits.
Contact Dermatitis (A Gimenez-Arnau, Section Editor)
Introduction Hand eczema (HE) is a common disease, with a 1-year prevalence around 10% in the background population [1], 21% among health care workers (HCW) [2•], 38% among hairdressers [3], and 12–15% among cleaners [4, 5]. Therefore, focus on prevention is pivotal to decrease incidence and prevalence, as well as severity of the disease [1, 6]. The prevalence among women is almost twice that of men, one-third of all cases of HE has its onset before 20 years of age [7], and occupational HE has an early onset with a mean of 36 years [8, 9]. Characterized by a chronic course with intermittent relapses, HE often results in a poor prognosis that affects multiple aspects of the patient’s life [10, 11]. Personal and societal costs of HE are high, including an impaired health-related quality of life (HR-QoL), compromised affiliation to the job market, and increased sick leave [12, 13]. The costs of illn
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