An overview of skin scores used for quantifying hand eczema: A critical update according to the criteria of evidence-based medicine

British Journal of Dermatology

Volumn 162, Issue 2, 2010, Pages 239-250

  Weistenhofer W ^a   Baumeister, T ^a   Drexler, H ^a   Kutting B ^a  

^a UNIVERSITY OF ERLANGEN NUREMBERG   (Germany)

Author keywords

Evidence based medicine; Hand eczema; Skin score

Indexed keywords

CLINICAL EXAMINATION; CLINICAL PRACTICE; DISEASE SEVERITY; EVIDENCE BASED MEDICINE; HAND ECZEMA; HUMAN; INTERRATER RELIABILITY; PRIORITY JOURNAL; REVIEW; SCORING SYSTEM; SCREENING TEST; SELF REPORT; SKIN STRUCTURE; VALIDATION STUDY;

ECZEMA; EVIDENCE-BASED MEDICINE; HAND DERMATOSES; HUMANS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; REPRODUCIBILITY OF RESULTS; SEVERITY OF ILLNESS INDEX;

EID: 74349100257     PISSN: 00070963     EISSN: 13652133     Source Type: Journal    
DOI: 10.1111/j.1365-2133.2009.09463.x     Document Type: Review

References (98)

1. Fredriksson T, Pettersson U. Severe psoriasis - oral therapy with a new retinoid. Dermatologica 1978 157 : 238 244.
2. European Task Force on Atopic Dermatitis. Severity scoring of atopic dermatitis: the SCORAD Index. Consensus report of the European Task Force on Atopic Dermatitis. Dermatology 1993 186 : 23 31.
3. Sugarman JL, Fluhr JW, Fowler AJ et al. The objective severity assessment of atopic dermatitis score. Arch Dermatol 2003 139 : 1417 1422.
4. Charman C, Chambers C, Williams H. Measuring atopic dermatitis severity in randomized controlled clinical trials: what exactly are we measuring? J Invest Dermatol 2003 120 : 932 941.
5. Agner T, Andersen KE, Brandao FM et al. Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients. Contact Dermatitis 2008 59 : 43 7.
6. Van Coevorden AM, Coenraads PJ, Svensson A et al. European Dermato-Epidemiology Network (EDEN). Overview of studies of treatments for hand eczema - the EDEN hand eczema survey. Br J Dermatol 2004 151 : 446 451.
7. Meding B, Järvholm B. Incidence of hand eczema - a population-based retrospective study. J Invest Dermatol 2004 122 : 873 877.
8. Meding B, Järvholm B. Hand eczema in Swedish adults - changes in prevalence between 1983 and 1996. J Invest Dermatol 2002 118 : 719 723.
9. Fowler JF, Duh MS, Chang J et al. A survey-based assessment of the prevalence and severity of chronic hand dermatitis in a managed care organization. Cutis 2006 77 : 385 392.
10. Ruzicka T, Lynde CW, Jemec GBE et al. Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial. Br J Dermatol 2008 158 : 808 817.
11. Rosenberg W, Donald A. Evidence-based medicine: an approach to clinical problem-solving. BMJ 1995 310 : 1122 1126.
12. Sackett DL, Straus SE, Richardson WS et al. Evidence-based Medicine. How to Practice and Teach, 2nd edn. London : Churchill Livingstone, 2000.
13. Allison JJ, Kiefe CI, Weissman NW et al. The art and science of searching Medline to answer clinical questions. Finding the right number of articles. Int J Technol Assess Health Care 1999 15 : 281 296.
14. Kütting B, Drexler H. Effectiveness of skin protection creams as a preventive measure in occupational dermatitis: a critical update according to criteria of evidence-based medicine. Int Arch Occup Environ Health 2003 76 : 253 259.
15. Adams S, Bayerl C. Medium-dose-UVA-1 irradiation and topical PUVA-therapy in chronic dyshidrotic hand dermatitis - a prospective randomized study. Akt Dermatol 2007 33 : 142 145.
16. Aubin F, Vigan M, Puzenat E et al. Evaluation of a novel 308-nm monochromatic excimer light delivery system in dermatology: a pilot study in different chronic localized dermatoses. Br J Dermatol 2005 152 : 99 103.
17. Baskan EB, Kacar SD, Tunali S. The efficacy of topical pimecrolimus cream 1% in hand dermatitis. J Eur Acad Dermatol Venereol 2005 19 (Suppl. 2 267.
18. Bauer A, Kelterer D, Stadeler M et al. The prevention of occupational hand dermatitis in bakers, confectioners and employees in the catering trades. Contact Dermatitis 2001 44 : 85 8.
19. Bayerl C, Garbea A, Peiler D et al. Pilot study for the treatment of occupational hand dermatitis with a new portable UVB irradiation unit. Akt Dermatol 1999 25 : 302 305.
20. Berndt U, Wigger-Alberti W, Gabard B, Elsner P. Efficacy of a barrier cream and its vehicle as protective measures against occupational irritant contact dermatitis. Contact Dermatitis 2000 42 : 77 80.
21. Bollag W, Ott F. Successful treatment of chronic hand eczema with oral 9-cis-retinoic acid. Dermatology 1999 199 : 308 312.
22. Cherill R, Tofte S, MacNaul R et al. SDZ ASM 1% cream is effective in the treatment of chronic irritant hand dermatitis: a 6-week, randomized, double-blind, vehicle-controlled, single center study. Contact Dermatitis 2000 42 (Suppl. 16 17.
23. Dulon M, Skudlik C, Nübling M et al. Validity and responsiveness of the Osnabrück Hand Eczema Severity Index (OHSI): a methodological study. Br J Dermatol 2009 160 : 137 142.
24. Engin B, Oguz O. Evaluation of time-dependent response to psoralen plus UVA (PUVA) treatment with topical 8-methoxypsoralen (8-MOP) gel in palmoplantar dermatoses. Int J Dermatol 2005 44 : 337 339.
25. Faghihi G, Iraji F, Shahingohar A, Saidat AH. The efficacy of '0.05% clobetasol+2.5% zinc sulphate' cream vs. '0.05% clobetasol alone' cream in the treatment of the chronic hand eczema: a double-blind study. J Eur Acad Dermatol Venereol 2008 22 : 531 536.
26. Frosch PJ, Peiler D, Grunert V, Grunenberg B. Efficacy of barrier creams in comparison to skin care products in dental laboratory technicians - a controlled trial. J Dtsch Dermatol Ges 2003 1 : 547 557.
27. Granlund H, Erkko P, Eriksson E, Reitamo S. Comparison of cyclosporine and topical betamethasone-17,21-dipropionate in the treatment of severe chronic hand eczema. Acta Derm Venereol (Stockh) 1996 76 : 371 376.
28. Granlund H, Erkko P, Reitamo S. Long-term follow-up of eczema patients treated with cyclosporine. Acta Derm Venereol (Stockh) 1998 78 : 40 3.
29. Grattan CEH, Carmichael AJ, Shuttleworth GJ, Foulds IS. Comparison of topical PUVA with UVA for chronic vesicular hand eczema. Acta Derm Venereol (Stockh) 1991 71 : 118 122.
30. Gritiyarangsan P, Sukhum A, Tresukosol P, Kullavanijaya P. Topical PUVA therapy for chronic hand eczema. J Dermatol 1998 25 : 299 301.
31. Gupta AK, Shear NH, Lester RS et al. Betamethasone dipropionate polyacrylic film-forming lotion in the treatment of hand dermatitis. Int J Dermatol 1993 32 : 828 829.
32. Hachem JP, De Paepe K, Sterckx G et al. Evaluation of biophysical and clinical parameters of skin barrier function among hospital workers. Contact Dermatitis 2002 46 : 220 223.
33. Hald M, Agner T, Blands J et al. Clinical severity and prognosis of hand eczema. Br J Dermatol 2009 160 : 1229 1236.
34. Halkier-Sörensen L, Thestrup-Pedersen K. The efficacy of a moisturizer (Locobase) among cleaners and kitchen assistants during everyday exposure to water and detergents. Contact Dermatitis 1993 29 : 266 271.
35. Hanifin JM, Stevens V, Sheth P, Breneman D. Novel treatment of chronic severe hand dermatitis with bexarotene gel. Br J Dermatol 2004 150 : 545 553.
36. Held E, Skoet R, Johansen JD, Agner T. The hand eczema severity index (HECSI): a scoring system for clinical assessment of hand eczema. A study of inter- and intraobserver reliability. Br J Dermatol 2005 152 : 302 307.
37. Hill VA, Wong E, Corbett MF, Menday AP. Comparative efficacy of betamethasone/clioquinol (Betnovate-C) cream and betamethasone/fusidic acid (Fucibet) cream in the treatment of infected hand eczema. J Dermatolog Treat 1998 9 : 15 19.
38. John SM. Diagnostics in the investigation of occupational skin diseases - I: Operationalisation of the clinical findings (Manuscore). In : Clinical and Experimental Studies of the Diagnostics in Occupational Dermatology (John SM, ed). Osnabrück : Universitätsverlag Rasch, 2001 133 141.
39. John SM, Uter W, Schwanitz HJ. Relevance of multiparametric skin bioengineering in a prospectively followed cohort of junior hairdressers. Contact Dermatitis 2000 43 : 161 168.
40. Kampf G, Wigger-Alberti W, Schoder V, Wilhelm KP. Emollients in a propanol-based hand rub can significantly decrease irritant contact dermatitis. Contact Dermatitis 2005 53 : 344 349.
41. Krejci-Manwaring J, McCarty MA, Camacho F et al. Topical tacrolimus 0.1% improves symptoms of hand dermatitis in patients treated with a prednisone taper. J Drugs Dermatol 2008 7 : 643 646.
42. Krutmann J, Medve-Koenigs K, Ruzicka T et al. Ultraviolet-free phototherapy. Photodermatol Photoimmunol Photomed 2005 21 : 59 61.
43. Kucharekova M, Van de Kerkhof PCM, Van der Valk PGM. A randomized comparison of an emollient containing skin-related lipids with a petroleum-based emollient as adjunct in the treatment of chronic hand dermatitis. Contact Dermatitis 2003 48 : 293 299.
44. Lerbaek A, Kyvik KO, Ravn H et al. Clinical characteristics and consequences of hand eczema - an 8-year follow-up study of a population-based twin cohort. Contact Dermatitis 2008 58 : 210 216.
45. Lindelöf B, Wrangsjö K, Lidén S. A double-blind study of Grenz therapy in chronic eczema of the hands. Br J Dermatol 1987 117 : 77 80.
46. Löffler H, Bruckner T, Diepgen T, Effendy I. Primary prevention in health care employees: a prospective intervention study with a 3-year training period. Contact Dermatitis 2006 54 : 202 209.
47. McCormick RD, Buchman TL, Maki DG. Double-blind, randomized trial of scheduled use of a novel barrier cream and an oil-containing lotion for protecting the hands of health care workers. Am J Infect Control 2000 28 : 302 310.
48. Mirza R, Maani N, Liu C et al. A randomized, controlled, double-blind study of the effect of wearing coated pH 5.5 latex gloves compared with standard powder-free latex gloves on skin pH, transepidermal water loss and skin irritation. Contact Dermatitis 2006 55 : 20 5.
49. Odia S, Vocks E, Rakoski J, Ring J. Successful treatment of dyshidrotic hand eczema using tap water iontophoresis with pulsed direct current. Acta Derm Venereol (Stockh) 1996 76 : 472 474.
50. Petering H, Breuer C, Herbst R et al. Comparison of localized high-dose UVA1 irradiation versus topical cream psoralen-UVA for treatment of chronic vesicular dyshidrotic eczema. J Am Acad Dermatol 2004 50 : 68 72.
51. Polderman MCA, Govaert JCM, le Cessie S, Pavel S. A double-blind placebo-controlled trial of UVA-1 in the treatment of dyshidrotic eczema. Clin Exp Dermatol 2003 28 : 584 587.
52. Reilly MC, Lavin PT, Kahler KH, Pariser DM. Validation of the Dermatology Life Quality Index and the Work Productivity and Activity Impairment-Chronic Hand Dermatitis questionnaire in chronic hand dermatitis. J Am Acad Dermatol 2003 48 : 128 130.
53. Rosén K, Mobacken H, Swanbeck G. Chronic eczematous dermatitis of the hands: a comparison of PUVA and UVB treatment. Acta Derm Venereol (Stockh) 1987 67 : 48 54.
54. Rosén K, Jontell M, Mobacken H, Rosdahl I. Epidermal Langerhans cells in chronic eczematous dermatitis of the palms treated with PUVA and UVB. Acta Derm Venereol (Stockh) 1989 69 : 200 205.
55. Ruzicka T, Larsen FG, Galewicz D et al. Oral alitretinoin (9-cis-retinoic acid) therapy for chronic hand dermatitis in patients refractory to standard therapy. Arch Dermatol 2004 140 : 1453 1459.
56. Schiener R, Gottlöber P, Müller B et al. PUVA-gel vs. PUVA-bath therapy for severe recalcitrant palmoplantar dermatoses. A randomized, single-blinded prospective study. Photodermatol Photoimmunol Photomed 2005 21 : 62 7.
57. Schliemann S, Kelterer D, Bauer A et al. Tacrolimus ointment in the treatment of occupationally induced chronic hand dermatitis. Contact Dermatitis 2008 58 : 299 306.
58. Schmidt T, Abeck D, Boeck K et al. UVA1 irradiation is effective in treatment of chronic vesicular dyshidrotic hand eczema. Acta Derm Venereol (Stockh) 1998 78 : 318 319.
59. Schnopp C, Remling R, Möhrenschlager M et al. Topical tacrolimus (FK506) and mometasone furoate in treatment of dyshidrotic palmar eczema: a randomized, observer-blinded trial. J Am Acad Dermatol 2002 46 : 73 7.
60. Schürer NY, Klippel U, Schwanitz HJ. Secondary individual prevention of hand dermatitis in geriatric nurses. Int Arch Occup Environ Health 2005 78 : 149 157.
61. Sezer E, Etikan I. Local narrowband UVB phototherapy vs. local PUVA in the treatment of chronic hand eczema. Photodermatol Photoimmunol Photomed 2007 23 : 10 14.
62. Sharma AD. Disulfiram and low nickel diet in the management of hand eczema: a clinical study. Indian J Dermatol Venereol Leprol 2006 22 : 113 118.
63. Simons JR, Bohnen IJ, Van der Valk PG. A left-right comparison of UVB phototherapy and topical phototherapy in bilateral chronic hand dermatitis after 6 weeks' treatment. Clin Exp Dermatol 1997 22 : 7 10.
64. ® in the clinic and at home. Contact Dermatitis 1994 31 : 5 8.
65. Skudlik C, Dulon M, Pohrt U et al. Osnabrück hand eczema severity index - a study of the interobserver reliability of a scoring system assessing skin diseases of the hands. Contact Dermatitis 2006 55 : 42 7.
66. Skudlik C, Dulon M, Wendeler D et al. Hand eczema in geriatric nurses in Germany - prevalence and risk factors. Contact Dermatitis 2009 60 : 136 143.
67. Swartling C, Naver H, Lindberg M, Anveden I. Treatment of dyshidrotic hand dermatitis with intradermal botulinum toxin. J Am Acad Dermatol 2002 47 : 667 671.
68. Thaçi D, Steinmeyer K, Ebelin ME et al. Occlusive treatment of chronic hand dermatitis with pimecrolimus cream 1% results in low systemic exposure, is well tolerated, safe, and effective. Dermatology 2003 207 : 37 42.
69. Thelmo MC, Lang W, Brooke E et al. An open-label pilot study to evaluate the safety and efficacy of topically applied tacrolimus ointment for the treatment of hand and/or foot eczema. J Dermatolog Treat 2003 14 : 136 140.
70. Thestrup-Pedersen K, Andersen KE, Menné T, Veien NK. Treatment of hyperkeratotic dermatitis of the palms (eczema keratoticum) with oral acitretin. A single-blind placebo-controlled study. Acta Derm Venerol 2001 81 : 353 355.
71. Uter W, Gefeller O, Schwanitz HJ. Early-onset irritant skin damage in apprentice hairdressers [in German]. Hautarzt 1995 46 : 771 778.
72. Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Hand eczema in a prospective-followed cohort of office-workers. Contact Dermatitis 1998 38 : 83 9.
73. Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Prevalence and incidence of hand dermatitis in hairdressing apprentices: results of the POSH study. Int Arch Occup Environ Health 1998 71 : 487 492.
74. Van Coevorden AM, van Sonderen E, Bouma J, Coenraads PJ. Assessment of severity of hand eczema: discrepancies between patient- and physician-rated scores. Br J Dermatol 2006 155 : 1217 1222.
75. Van Coevorden AM, Kamphof WG, van Sonderen E et al. Comparison of oral psoralen-UV-A with a portable tanning unit at home vs hospital-administered bath psoralen-UV-A in patients with chronic hand eczema. Arch Dermatol 2004 140 : 1463 1466.
76. Veien NK, Kaaber K, Larsen PO et al. Ranitidine treatment of hand eczema in patients with atopic dermatitis: a double-blind, placebo-controlled trial. J Am Acad Dermatol 1995 32 : 1056 1057.
77. Veien NK, Olholm Larsen P, Thestrup-Pedersen K, Schou G. Long-term, intermittent treatment of chronic hand eczema with mometasone furoate. Br J Dermatol 1999 140 : 882 886.
78. Veien NK, Hattel T, Laurberg G. Hand eczema: causes, course, and prognosis I. Contact Dermatitis 2008 58 : 330 334. (Pubitemid 351733068)
79. Vocks E, Plötz SG, Ring J. The Dyshidrotic Eczema Area and Severity Index - a score developed for the assessment of dyshidrotic eczema. Dermatology 1999 198 : 265 269.
80. Wollina U, Karamfilov T. Adjuvant botulinum toxin A in dyshidrotic hand eczema: a controlled prospective pilot study with left-right comparison. J Eur Acad Dermatol Venereol 2002 16 : 40 2.
81. Zhai H, Schmidt R, Levin C et al. Prevention and therapeutic effects of a model emulsion on glove-induced irritation and dry skin in man. Occup Environ Dermatol 2002 50 : 134 138.
82. Charman CR, English JS. Getting to grips with hand eczema: measuring skin disease severity objectively. Br J Dermatol 2005 152 : 199 201.
83. Diepgen TL, Andersen KE, Brandao FM et al. Hand eczema classification: a cross-sectional, multicentre study of the aetiology and morphology of hand eczema. Br J Dermatol 2009 160 : 353 358.
84. Bauer A, Bartsch R, Stadeler M et al. Development of occupational skin diseases during vocational training in baker and confectioner apprentices. Contact Dermatitis 1998 39 : 307 311.
85. Bauer A, Bartsch R, Hersmann C et al. Occupational hand dermatitis in food industry apprentices: results of a 3-year follow-up cohort study. Int Arch Environ Health 2001 74 : 437 442.
86. Möller H, Svartholm H, Dahl G. Intermittent maintenance therapy in chronic hand eczema with clobetasol propionate and flupredniden acetate. Curr Med Res Opin 1983 8 : 640 644.
87. Rosén K. Pustulosis palmoplantaris and chronic eczematous hand dermatitis. Treatment, epidermal Langerhans cells and association with thyroid disease. Acta Derm Venereol Suppl (Stockh) 1988 137 : 1 52.
88. Sjövall P, Christensen OB. Local and systemic effect of UVB irradiation in patients with chronic hand eczema. Acta Derm Venereol 1987 67 : 538 541.
89. Bruynzeel DP, Boonk WJ, van Ketel WG. Oral psoralen photochemotherapy of allergic contact dermatitis of the hands. Derm Beruf Umwelt 1982 30 : 16 20.
90. Schall S, Poth DO. An evaluation of hand eczema treatment with fluocinolone acetonide cream, and fluocinolone acetonide cream and Grenz ray. Ind Med Surg 1965 34 : 51 2.
91. Schempp CM, Müller H, Czech W et al. Treatment of chronic palmoplantar eczema with local bath-PUVA therapy. J Am Acad Dermatol 1997 36 : 733 737.
92. King CM, Chalmers RJ. A double-blind study of superficial radiotherapy in chronic palmar eczema. Br J Dermatol 1984 111 : 451 454.
93. Fowler JF Jr. A skin moisturizing cream containing quaternium-18- bentonite effectively improves chronic hand dermatitis. J Cutan Med Surg 2001 5 : 201 205.
94. Fowler JF Jr. Efficacy of a skin-protective foam in the treatment of chronic hand dermatitis. Am J Contact Dermat 2000 11 : 165 169.
95. ®) in the treatment of chronic hand dermatitis: disappointing therapeutic results. Dermatology 1996 193 : 115 120.
96. Curr N, Dharmage S, Keegel T et al. The validity and reliability of the occupational contact dermatitis disease severity index. Contact Dermatitis 2008 59 : 157 164.
97. Stuetz A, Grassberger M, Meingassner JG. Pimecrolimus (Elidel, SDZ ASM 981) - preclinical pharmacologic profile and skin selectivity. Semin Cutan Med Surg 2001 20 : 233 241.
98. ®, SDZ ASM 981) after occlusive topical treatment of chronic hand dermatitis. J Eur Acad Dermatol Venereol 2001 15 (Suppl. 2 196.