Apfelbacher C, Weiß M, Molin S, Bauer A, Mahler V, Schmitt J, Elsner P, Diepgen T L, Weisshaar E
Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital, Ruprecht Karls University Heidelberg, Heidelberg, Germany.
J Eur Acad Dermatol Venereol. 2016 Jan;30(1):50-6. doi: 10.1111/jdv.13398. Epub 2015 Oct 14.
Antihistamines (AH) are often used to treat chronic skin diseases related to allergy and/or pruritus. Data on the use of AH in patients with chronic hand eczema (CHE) is scarce.
The objective of this study was to investigate prevalence and determinants of AH use in patients with CHE.
Data were drawn from the German CARPE registry. The relationship of clinical, demographic and treatment-related variables with AH use in the past 12 months was analysed by means of logistic regression. Odds ratios (OR) with corresponding 95% confidence intervals (CIs) were computed.
A total of 1255 patients with CHE were eligible for analysis (54.1% female; mean age: 47.1 years, standard deviation (SD) 13.6 years). Mean subjective disease severity was 5.0 (SD 2.5). 25% of the sample reported to have used AH in the past 12 months. Significant positive associations with AH use were identified for moderate (OR = 3.05, 95% CI 1.81-5.15) or severe (OR = 4.27, 95% CI 2.40-7.59) pruritus, a history of systemic treatment (e.g. alitretinoin) (OR = 2.85, 95% CI: 2.06-3.96), UV phototherapy (OR = 1.78, 95% CI 1.28-2.46), flexural eczema (OR = 1.89, 95% CI 1.32-2.71), allergic rhinitis/conjunctivitis (OR = 2.41, 95% CI 1.71-3.39) and female gender (OR = 1.58, 95% CI 1.16-2.14) in multivariate analyses (N = 1184). Significant inverse associations were found for an eczema localization besides the hands (OR = 0.66, 95% CI 0.46-0.94) and for patients being recruited in hospital (vs. dermatological practice; OR = 0.47, 95% CI 0.33-0.67).
This study suggests that AH use is frequent in patients with CHE and mainly related to female gender, disease severity, pruritus, comorbid atopic disease and treatment centre.
抗组胺药（AH）常用于治疗与过敏和/或瘙痒相关的慢性皮肤病。关于AH在慢性手部湿疹（CHE）患者中的使用数据较少。
本研究的目的是调查CHE患者中AH的使用情况及其影响因素。
数据来自德国CARPE注册库。通过逻辑回归分析临床、人口统计学和治疗相关变量与过去12个月内AH使用之间的关系。计算比值比（OR）及相应的95%置信区间（CI）。
共有1255例CHE患者符合分析条件（女性占54.1%；平均年龄：47.1岁，标准差（SD）13.6岁）。主观疾病严重程度平均为5.0（SD 2.5）。25%的样本报告在过去12个月内使用过AH。多因素分析（N = 1184）显示，中度（OR = 3.05，95% CI 1.81 - 5.15）或重度（OR = 4.27，95% CI 2.40 - 7.59）瘙痒、系统治疗史（如阿利维A酸）（OR = 2.85，95% CI：2.06 - 3.�6）、紫外线光疗（OR = 1.78，95% CI 1.28 - 2.46）、屈侧湿疹（OR = 1.89，95% CI 1.32 - 2.71）、过敏性鼻炎/结膜炎（OR = 2.41，95% CI 1.71 - 3.39）以及女性（OR = 1.58，95% CI 1.16 - 2.14）与AH使用呈显著正相关。手部以外部位的湿疹（OR = 0.66，95% CI 0.46 - 0.94）以及在医院招募的患者（与皮肤科诊所相比；OR = 0.47，95% CI 0.33 - 0.67）与AH使用呈显著负相关。
本研究表明，CHE患者中AH的使用较为频繁且主要与女性性别、疾病严重程度、瘙痒、合并特应性疾病及治疗中心有关。
