Exposure and work‐related factors in subjects with hand eczema: Data from a cross‐sectional questionnaire within the Lifelines Cohort Study

BACKGROUND: Hand eczema (HE) is the most frequently occurring occupational skin disease. However, studies on non‐occupational wet exposure, occupations not considered as high‐risk, and socioeconomic factors regarding HE are scarce. OBJECTIVES: To investigate the association between HE and occupational and non‐occupational wet exposure and work‐related factors in the Dutch general population. METHODS: Within the Lifelines Cohort Study, participants with HE were identified by a digital, add‐on questionnaire that included questions regarding exposure. Data on work‐related and socioeconomic factors were collected from baseline. RESULTS: Overall, 57 046 participants (42.0%) were included. Occupational and non‐occupational wet exposure were positively associated with HE in the past year (odds ratios (ORs) 1.35, [95% confidence interval (CI): 1.22–1.49] and 1.34, [95%CI: 1.17‐1.53], respectively). Positive associations for high‐risk occupations (OR 1.20, [95%CI: 1.06‐1.36] for personal care workers in health services and OR 1.25, [95%CI: 1.06‐1.48] for nursing and midwifery professionals), occupations not considered as high‐risk (OR 1.19, [95%CI: 1.03‐1.39] for legal, social and religious associate professionals) and higher levels of education were found (OR 1.17, [95%CI: 1.04‐1.32] and OR 1.18, [95%CI: 1.04‐1.34] for middle and high level, respectively). CONCLUSION: Preventive strategies for HE should focus on avoidance of all wet exposure, regardless of origin. In addition, job tasks instead of job title should be taken into account. As previous results on the association between HE and socioeconomic factors differ, future research should focus on a uniform definition of socioeconomic status

The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis:52 week results from the Dutch BioDay Registry

Background: The hands are a common predilection site of atopic dermatitis (AD). Dupilumab is licensed for the treatment of AD but not for chronic hand eczema (CHE), while CHE is challenging to treat. Objectives: To evaluate the long-term effect of dupilumab on hand eczema (HE) in patients with AD from the BioDay Registry. Methods: A prospective observational study of adult patients with HE, treated for AD with dupilumab. Patients with a HE severity of at least moderate at baseline were considered for analysis. Patients with other concomitantly systemic immunosuppressive treatments were excluded. Clinical effectiveness on HE severity, using the Hand Eczema Severity Index (HECSI) and photographic guide, and health-related quality of life, using the Quality of Life in Hand Eczema Questionnaire (QOLHEQ), were evaluated. Results: A total of 72 patients were included. HECSI-75 was achieved by 54/62 patients (87.1%) and HECSI-90 by 39/72 (62.9%) at 52 weeks. Based on the photographic guide, 56/62 patients (90.3%) achieved the endpoint of ‘clear’ or ‘almost clear’. Mean QOLHEQ reduction was −63.5% (95% confidence interval −38.23 to −27.41). There was no difference in response between HE subtypes. Conclusions: The results from this study hold promise for dupilumab to be a suitable treatment option for isolated CHE