Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark.
Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark.
J Eur Acad Dermatol Venereol. 2024 Nov;38(11):2110-2117. doi: 10.1111/jdv.20140. Epub 2024 May 29.
Living with hand eczema (HE) has been associated with impaired quality of life (QoL), having anxiety and depression but the magnitude of association is not clear.
The aim of this systematic review and meta-analysis was to determine the psychological burden in terms of anxiety, depression and quality of life in patients with HE.
Several databases were systematically searched. Weighted means with standard deviation (SD) were calculated for disease severity, QoL, depression and/or anxiety scores among patients with HE. For studies presenting QoL, depression and/or anxiety scores in patients with HE and in controls the weighted means were compared with an unpaired t-test. In studies reporting Hand Eczema Severity Index (HECSI) and Dermatology Life Quality Index (DLQI), the correlation between HECSI and DLQI was estimated using Spearman's rank correlation (rs).
In total, 81 studies encompassing 17,835 patients with HE and 31,541 controls were included. The weighted mean DLQI was 10.66 (SD 8.93) corresponding to a moderate-to-large effect on QoL and a strong correlation (r: 0.76, 95% CI:0.56-0.87) between DLQI and HECSI was observed. The mean EQ-5D-VAS was significantly lower in patients with HE compared with controls (68.03 (SD 10.52) vs. 80.63 (SD 1.17), p < 0.00001). Patients with HE had higher mean HADS (Hospital Anxiety and Depression Scale) anxiety score (7.4 vs. 5.8, p = 0.0008) than controls but not higher HADS depression score (6.5 vs. 5.7, p = 0.32). Only one study assessed risk of anxiety, depression and suicidal ideation showing an increased odds of all diseases among patients with HE compared with controls.
Hand eczema has a moderate-to-severe impact on quality of life with a strong correlation between disease severity and impact on quality of life. Patients with hand eczema have an impact on QoL comparable to other chronic diseases when measured with generic QoL scoring systems.
手部湿疹（HE）患者的生活质量（QoL）受损，伴有焦虑和抑郁，但关联程度尚不清楚。
本系统评价和荟萃分析旨在确定 HE 患者的焦虑、抑郁和生活质量的心理负担。
系统检索多个数据库。计算 HE 患者疾病严重程度、生活质量、抑郁和/或焦虑评分的加权均数和标准差。对于报告 HE 患者和对照组生活质量、抑郁和/或焦虑评分的研究，采用配对 t 检验比较加权均数。对于报告手部湿疹严重指数（HECSI）和皮肤病生活质量指数（DLQI）的研究，采用 Spearman 秩相关（rs）估计 HECSI 和 DLQI 之间的相关性。
共纳入 81 项研究，共纳入 17835 例 HE 患者和 31541 例对照组。加权平均 DLQI 为 10.66（SD 8.93），对生活质量有中度至较大影响，DLQI 和 HECSI 之间存在很强的相关性（r：0.76，95%CI：0.56-0.87）。与对照组相比，HE 患者的 EQ-5D-VAS 均值明显较低（68.03（SD 10.52）vs.80.63（SD 1.17），p<0.00001）。与对照组相比，HE 患者的 HADS（医院焦虑和抑郁量表）焦虑评分均值较高（7.4 与 5.8，p=0.0008），但 HADS 抑郁评分均值较高（6.5 与 5.7，p=0.32）。仅有一项研究评估了焦虑、抑郁和自杀意念的风险，结果显示 HE 患者的所有疾病的患病风险均高于对照组。
手部湿疹对生活质量有中度至重度影响，疾病严重程度与生活质量的影响有很强的相关性。当使用通用生活质量评分系统测量时，手部湿疹患者的生活质量影响与其他慢性疾病相当。
