Abstract
Chronic hand eczema is a multifactorial disease that can impact quality of life considerably. This observational questionnaire study aimed to investigate real-world treatments and patients' experiences of disease burden across the broad severity spectrum represent-ed by the general chronic hand eczema population. The study included 1,948 individuals from 6 countries (mean age 43.2 years; 64.5% females) with self-reported physician-diagnosed chronic hand eczema. Ongoing treatment was reported in 68.6%, which included systemics or phototherapy (with or without topicals; 10.7%), topical corticosteroids (with or without additional topicals; 36.0%) and other topical treatments (no topical corticosteroids; 21.8%). At survey time, 43.0% were in flare state. About half, 51.1%, reported moderate to severe disease signs (past week). Treatment with topical corticosteroids was suboptimal in 9.7% of those with moderate to severe disease. Experience of symptoms was common, particularly itch. Symptom burden differed significantly between groups with different treatments and severity levels; it was highest among those reporting systemics/phototherapy and those for whom topical corticosteroids were suboptimal. The results indicate that, despite a high treatment rate, chronic hand eczema is associated with a considerable disease burden that varies significantly across the severity spectrum. A particularly high burden in treatment stages beyond topical corticosteroids indicates a need for more effective management of symptoms.