Department of Dermatology, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Department of Occupational and Environmental Medicine, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Contact Dermatitis. 2022 Dec;87(6):528-534. doi: 10.1111/cod.14183. Epub 2022 Jul 21.
The accuracy of self-reported hand eczema (HE) is currently unclear, and it is unknown how well self-reported signs and symptoms of skin lesions that indicate HE correlate with self-reported HE.
To correlate self-reported signs and symptoms of skin lesions on the hands with self-reported HE, to assess the sensitivity and specificity, and to suggest a definition for HE.
Seven hundred ninety-five (47.8%) of 1663 invited healthcare workers completed a digital questionnaire, and were asked to report if they experienced HE or any of the following skin signs/symptoms in past 11 months: scaling, erythema, fissures, vesicles, dryness, itch, stinging.
HE during the past 11 months was reported by 11.9%. Of these, 91.4% reported at least one skin sign versus 32.3% of those without self-reported HE. The highest sensitivity and specificity were found for erythema (77.4% and 78.2%, respectively) and itch (78.5% and 78.6%, respectively), both separately and combined. The combination of ≥2 signs (erythema, scaling, fissures and vesicles) and itch, reached a sensitivity of 52.7% and specificity of 93.9%.
The marked difference between self-reported HE and signs/symptoms highlights the importance of differentiating between data based on self-reported HE and signs/symptoms. As a first step towards diagnostic HE criteria, ≥2 signs combined with itch could be considered, but clinical studies are needed to verify the precision.
目前尚不清楚自我报告的手部湿疹（HE）的准确性，也不知道指示 HE 的手部皮损的自我报告体征和症状与自我报告的 HE 相关程度如何。
将手部皮损的自我报告体征和症状与自我报告的 HE 相关联，评估其敏感性和特异性，并提出 HE 的定义。
在 1663 名受邀的医护人员中，有 795 名（47.8%）完成了数字问卷调查，并被要求报告他们在过去 11 个月中是否经历过 HE 或任何以下手部皮肤体征/症状：鳞屑、红斑、皲裂、水疱、干燥、瘙痒、刺痛。
过去 11 个月中有 11.9%的人报告患有 HE。其中，91.4%的人报告至少有一种皮肤体征，而没有自我报告 HE 的人中只有 32.3%的人报告有皮肤体征。红斑（分别为 77.4%和 78.2%）和瘙痒（分别为 78.5%和 78.6%）的敏感性和特异性最高，单独和联合使用时均如此。≥2 种体征（红斑、鳞屑、皲裂和水疱）和瘙痒的组合，其敏感性为 52.7%，特异性为 93.9%。
自我报告的 HE 与体征/症状之间的显著差异突出了区分基于自我报告的 HE 和体征/症状的数据的重要性。作为诊断 HE 标准的第一步，可以考虑≥2 种体征与瘙痒相结合，但需要进行临床研究以验证其准确性。
