Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland.
Centro Studio, Italian Group for Epidemiological Research in Dermatology (GISED), Bergamo, Italy.
Contact Dermatitis. 2018 Sep;79(3):136-148. doi: 10.1111/cod.13041. Epub 2018 Jun 25.
Hand eczema (HE) is common and may follow a chronic disease course. So far, prospective studies investigating the risk factors for disease progression as a prerequisite for targeted prevention are scarce.
To evaluate the overall association of HE-associated factors with clinical and quality of life (QoL) improvement during a follow-up of 2 years.
Data of the prospective patient cohort (N = 199) followed by the Swiss chronic HE (CHE) registry on long-term patient management (CARPE-CH) were analysed by means of both classic regression and semantic map analyses.
Both severity of HE and QoL significantly improved over the period of 2 years (P < .001). However, 20% of patients had moderate to severe HE after 2 years of follow-up. As factors associated with an unfavourable CHE clinical course and QoL, environmental exposures, male sex, occupational skin disease, job loss or change at baseline, allergic contact dermatitis, a chronic disease course, palmar localization and widespread eczema were identified.
Analysis of prospective data from CARPE-CH shows a complex pattern of associations among variables as shown by semantic map and classic statistical analyses. Factors related to occupational exposure had the highest impact on CHE.
手部湿疹（HE）很常见，且可能呈慢性病程。迄今为止，鲜有前瞻性研究调查疾病进展的危险因素，以作为针对性预防的前提。
评估 HE 相关因素与临床和生活质量（QoL）改善的整体关联，随访时间为 2 年。
通过经典回归和语义图分析，对瑞士慢性手部湿疹（CHE）登记处 CARPE-CH 进行长期患者管理随访的前瞻性患者队列（N=199）的数据进行分析。
在 2 年的随访期间，HE 的严重程度和 QoL 均显著改善（P<0.001）。然而，2 年后仍有 20%的患者存在中重度 HE。与 CHE 临床病程和 QoL 不良相关的因素包括环境暴露、男性、职业性皮肤病、基线时失业或工作变动、过敏性接触性皮炎、慢性病程、手掌定位和广泛湿疹。
CARPE-CH 的前瞻性数据分析显示，语义图和经典统计分析均表明变量之间存在复杂的关联模式。与职业暴露相关的因素对 CHE 的影响最大。
