Quality of life of patients with dyshidrotic eczema: a cross-sectional study
https://doi.org/10.21518/ms2024-310
Abstract
Introduction. Dyshidrotic eczema (DE) is a type of true eczema, prone to chronic recurrent course, which has a negative impact on the quality of life of patients. In the domestic literature, insufficient attention is paid to the study of the role and nature of the course of the disease on the daily life of patients with DE.
Aim. To study the quality of life in patients of DE. Provide a description of a clinical cases of DE and experience with external therapy.
Materials and methods. 105 patients with DE aged 18 to 52 years were included in the study, the mean age was 31.3 ± 8.1 years. The quality of life was assessed using the Dermatology Life Quality Index (DLQI). The Dyshidrotic Eczema Area and Severity Index (DASI) was used to clinically assess the severity of DE.
Results. All patients suffering from DE noted a negative impact of the skin process on the quality of life. At the same time, the average DLQI score in all patients was 6.99 ± 4.6, which indicates a moderate undesirable effect of DE on the quality of life, without statistically significant differences by gender. The average DASI score was 12.6 ± 8.8, which indicates a predominance of mild DE in the sample. In women, a process of moderate severity was more often diagnosed and the DASI index was 13.2 ± 8.5. The study demonstrated that the female gender is more susceptible to the influence of DE symptoms on the quality of life, regardless of the severity and extent of the skin process, and minimal changes in the skin can have a negative impact on the quality of life. The article presents clinical examples of successful treatment of DE localized on the skin of the hands with an external preparation containing a combination of 0.05% betamethasone dipropionate, 0.1% gentamicin sulfate and 1% clotrimazole.
Conclusion. DE is a common condition and affects quality of life. Proper diagnosis is essential for effective and efficient treatment. External therapy with the inclusion of a cream (ointment) containing a combination of 0.05% betamethasone dipropionate, 0.1% gentamicin sulfate and 1% clotrimazole gives better results and increases satisfaction with the treatment of patients with DE.
About the Authors
A. S. ShachnevRussian Federation
Aleksandr S. Shachnev, Postgraduate Student of the Department of Dermatovenereology, Allergology and Cosmetology, Institute of Medicine
6, Miklukho-Maklaya St., Moscow, 117198
O. V. Zhukova
Russian Federation
Olga V. Zhukova, Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenereology Allergology and Cosmetology, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba; Chief Medical Officer, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology
6, Miklukho-Maklaya St., Moscow, 117198,
17, Leninskiy Ave., Moscow, 119071
E. I. Kasikhina
Russian Federation
Elena I. Kasikhina, Cand. Sci. (Med.), Associate Professor, Department of Dermatovenereology, Allergology and Cosmetology, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba; Dermatologist, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology
6, Miklukho-Maklaya St., Moscow, 117198,
17, Leninskiy Ave., Moscow, 119071
References
1. Veien NK. Acute and recurrent vesicular hand dermatitis. Dermatologic Clinics. 2009;27(3):337–353. https://doi.org/10.1016/j.det.2009.05.013.
2. Calle Sarmiento PM, Chango Azanza JJ. Dyshidrotic Eczema: A Common Cause of Palmar Dermatitis. Cureus. 2020;12(10):e10839. https://doi.org/10.7759/cureus.10839.
3. Meding B, Swanbeck G. Epidemiology of different types of hand eczema in an industrial city. Acta Derm Venereol. 1989;69(3):227–233. https://doi.org/10.2340/0001555569227233.
4. Clément A, Ferrier le Bouëdec MC, Crépy MN, Raison-Peyron N, Tétart F et al. Hand eczema in glove-wearing patients. Contact Dermatitis. 2023;89(3):143–152. https://doi.org/10.1111/cod.14357.
5. Leung A, Barankin B, Hon EKL. Dyshidrotic Eczema. Enliven: Pediatr Neonatol Biol. 2014;1(1):002. https://doi.org/10.7759/cureus.10839.
6. Agner T, Elsner P. Hand eczema: epidemiology, prognosis and prevention. J Eur Acad Dermatol Venereol. 2020;34(1):4–12. https://doi.org/10.1111/jdv.16061.
7. Patel K, Nixon R. Irritant Contact Dermatitis – a Review. Curr Dermatol Rep. 2022;11(2):41–51. https://doi.org/10.1007/s13671-021-00351-4.
8. Teigen K, Höper A, Føreland S. Hand eczema and skin complaints in particulate matter-exposed occupations – firefighters, chimney sweepers, and ferrosilicon smelter workers in Norway. J Occup Med Toxicol. 2024;19:7. https://doi.org/10.1186/s12995-024-00407-8.
9. Thyssen JP, Schuttelaar MLA, Alfonso JH, Andersen KE, Angelova-Fischer I et al. Guidelines for diagnosis, prevention, and treatment of hand eczema. Contact Dermatitis. 2022;86(5):357–378. https://doi.org/10.1111/cod.14035.
10. Shachnev AS, Zhukova OV, Kasikhina EI. Dyshidrotic eczema: clinical and epidemiological features and therapy tactics. Meditsinskiy Sovet. 2024;18(5):230–238. (In Russ.) https://doi.org/10.21518/ms2024-081.
11. Koskelo M, Sinikumpu SP, Jokelainen J, Huilaja L. Risk factors of hand eczema: A population-based study among 900 subjects. Contact Dermatitis. 2022;87(6):485–491. https://doi.org/10.1111/cod.14205.
12. Koskelo M, Loman L, Schuttelaar MLA. Hand eczema and lifestyle factors in the Dutch general population: Evidence for smoking, chronic stress, and obesity. Contact Dermatitis. 2022;86(2):80–88. https://doi.org/10.1111/cod.14005.
13. Menné T, Johansen JD, Sommerlund M, Veien NK. Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema. Contact Dermatitis. 2011;65(1):3–12. https://doi.org/10.1111/j.1600-0536.2011.01915.x.
14. Lofgren SM, Warshaw EM. Dyshidrosis: epidemiology, clinical characteristics, and therapy. Dermatitis. 2006;4(17):165–181. https://doi.org/10.2310/6620.2006.05021.
15. Polecka A, Awchimkow A, Owsianko N, Baran A, Hermanowicz JM et al. Hand Eczema in the Polish Female Population. J Clin Med. 2023;12(18):6102. https://doi.org/10.3390/jcm12186102.
16. Tancredi V, Buononato D, Caccavale S, Di Brizzi EV, Di Caprio R, Argenziano G, Balato A et al. New Perspectives in the Management of Chronic Hand Eczema: Lessons from Pathogenesis. Int J Mol Sci. 2023;25(1):362. https://doi.org/10.3390/ijms25010362.
17. Meding B, Swanbeck G. Consequences of having hand eczema. Contact Dermatitis. 1990;23(1):6–14. https://doi.org/10.1111/j.1600-0536.1990.tb00076.x.
18. Diepgen TL, Agner T, Aberer W, Berth-Jones J, Cambazard F, Elsner P et. al. Management of chronic hand eczema. Contact Dermatitis. 2007;57(4):203–210. https://doi.org/10.1111/j.1600-0536.2007.01179.x.
19. Kouris A, Armyra K, Christodoulou C, Katoulis A, Potouridou I, Tsatovidou R et al. Quality of life, anxiety, depression and obsessive-compulsive tendencies in patients with chronic hand eczema. Contact Dermatitis. 2015;72(6):367–370. https://doi.org/10.1111/cod.12366.
20. Maden S, Ozbagcivan O, Onur Aysevener BE, Aktan S. Quality of life, anxiety, depression, social anxiety and avoidance in patients with chronic hand eczema. Ital J Dermatol Venerol. 2021;156(5):562–569. https://doi.org/10.23736/S2784-8671.21.06645-1.
21. Ho JSS, Molin SA. Review of Existing and New Treatments for the Management of Hand Eczema. J Cutan Med Surg. 2023;27(5):493–503. https://doi.org/10.1177/12034754231188325.
22. Armstrong A, Hahn-Pedersen J, Bartlett C, Glanville J, Thyssen JP. Economic Burden of Chronic Hand Eczema: A Review. Am J Clin Dermatol. 2022;23(3):287–300. https://doi.org/10.1007/s40257-021-00669-6.
23. Cvetkovski RS, Rothman KJ, Olsen J, Mathiesen B, Iversen L, Johansen JD, Agner T. Relation between diagnoses on severity, sick leave and loss of job among patients with occupational hand eczema. Br J Dermatol. 2005;152(1):93–98. https://doi.org/10.1111/j.1365-2133.2005.06415.x.
24. Cazzaniga S, Ballmer-Weber BK, Gräni N, Spring P, Bircher A, Anliker M et al. Medical, psychological and socio-economic implications of chronic hand eczema: a cross-sectional study. J Eur Acad Dermatol Venereol. 2016;30(4):628–637. https://doi.org/10.1111/jdv.13479.
25. Gladys TE, Maczuga S, Flamm A. Characterizing demographics and cost of care for dyshidrotic eczema. Contact Dermatitis. 2022;86(2):107–112. https://doi.org/10.1111/cod.14007.
26. Diepgen TL, Scheidt R, Weisshaar E, John SM, Hieke K. Cost of illnessnfrom occupational hand eczema in Germany. Contact Dermatitis. 2013;69:99–106. https://doi.org/10.1111/cod.12038.
27. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210–216. https://doi.org/10.1111/j.1365-2230.1994.tb01167.x.
28. Vocks E, Plötz SG, Ring J. The Dyshidrotic Eczema Area and Severity Index - A score developed for the assessment of dyshidrotic eczema. Dermatology. 1999;198(3):265–269. https://doi.org/10.1159/000018127.
29. Адаскевич ВП. Диагностические индексы в дерматологии. М.: Издательство Панфилова; 2014. 352 с.
30. Yu M, Han TY, Lee JH, Son SJ. The Quality of Life and Depressive Mood among Korean Patients with Hand Eczema. Ann Dermatol. 2012;24(4):430–437. https://doi.org/10.5021/ad.2012.24.4.430.
31. Agner T, Andersen KE, Brandao FM, Bruynzeel DP, Bruze M, Frosch P et al. Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients. Contact Dermatitis. 2008;59(1):43–47. https://doi.org/10.1111/j.1600-0536.2008.01362.x.
32. Ghaderi R, Saadatjoo A. Quality of life in patients with hand eczema as health promotion: a case control study. Acta Dermatovenerol Croat. 2014;22(1):32–39. Available at: https://pubmed.ncbi.nlm.nih.gov/24813839.
33. Politiek K, Ofenloch RF, Angelino MJ, van den Hoed E, Schuttelaar MLA. Quality of life, treatment satisfaction, and adherence to treatment in patients with vesicular hand eczema: A cross-sectional study. Contact Dermatitis. 2020;82(4):201–210. https://doi.org/10.1111/cod.13459.
34. Kataria V, Pandhi D, Bhattacharya SN. A cross-sectional study to analyze the clinical subtype, contact sensitization and impact of disease severity on quality of life and cost of illness in patients of hand eczema. Indian J Dermatol Venereol Leprol. 2020;86(6):663–668. https://doi.org/10.4103/ijdvl.IJDVL_333_18.
Review
For citations:
Shachnev AS, Zhukova OV, Kasikhina EI. Quality of life of patients with dyshidrotic eczema: a cross-sectional study. Meditsinskiy sovet = Medical Council. 2024;(14):14-22. (In Russ.) https://doi.org/10.21518/ms2024-310