Silverberg Jonathan I, Samynathan Archana, Thyssen Jacob P
Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue, Washington, DC, 20037, USA.
Department of Dermatology, George Washington University School of Medicine and Health Sciences, Medstar Washington Hospital Center, Washington, DC, USA.
Arch Dermatol Res. 2025 Mar 29;317(1):652. doi: 10.1007/s00403-025-04138-6.
Hand eczema (HE) is common among individuals with atopic dermatitis (AD), yet data on its prevalence and predictors in this population remain limited.
A prospective, dermatology practice-based study was performed in adult patients with AD to determine the prevalence of HE and associations with HE severity. AD severity was assessed using Investigator's Global Assessment (IGA), body surface area (BSA), Eczema Area and Severity Index (EASI), Scoring AD (SCORAD), objective component of SCORAD (O-SCORAD), Patient-reported Global AD severity (PtGA) and Patient-Oriented Eczema Measure (POEM).
Active HE was observed in 135 (45.9%) patients, including 83 (61.5%) with mild, 43 (31.9%) with moderate and 9 (6.7%) with severe HE. Lesions affected the dorsal hands or digits in 231 (78.6%), wrists in 69 (51.1%), palmar hands or digits in 113 (38.4%), with nail dystrophy present in only 7 (5.2%). There were no significant associations of HE severity with demographics or self-reported history of atopic disease. However, in bivariable and multivariable logistic regression models, HE severity was associated with moderate and severe IGA, BSA, EASI, SCORAD, O-SCORAD, PtGA and POEM.
HE was highly prevalent in adult patients with AD treated in the dermatology setting, particularly among patients with moderate-severe AD.
手部湿疹（HE）在特应性皮炎（AD）患者中很常见，但该人群中其患病率及预测因素的数据仍然有限。
对成年AD患者进行了一项基于皮肤科实践的前瞻性研究，以确定HE的患病率及其与HE严重程度的相关性。使用研究者整体评估（IGA）、体表面积（BSA）、湿疹面积和严重程度指数（EASI）、AD评分（SCORAD）、SCORAD的客观成分（O-SCORAD）、患者报告的AD整体严重程度（PtGA）和患者导向性湿疹测量（POEM）来评估AD严重程度。
135例（45.9%）患者观察到活动性HE，其中轻度HE患者83例（61.5%），中度HE患者43例（31.9%），重度HE患者9例（6.7%）。皮损累及手背或手指231例（78.6%），手腕69例（51.1%），手掌或手指113例（38.4%），仅7例（5.2%）有甲营养不良。HE严重程度与人口统计学特征或特应性疾病的自我报告病史无显著相关性。然而，在单变量和多变量逻辑回归模型中，HE严重程度与中度和重度IGA、BSA、EASI、SCORAD、O-SCORAD、PtGA和POEM相关。
在皮肤科就诊的成年AD患者中，HE非常普遍，尤其是在中度至重度AD患者中。
