Moderate to severe Chronic Hand Eczema in clinical practice: etiological subtypes, clinical signs and symptoms, and comorbidities—results from the RWEAL study

OBJECTIVES: Effective management of moderate to severe Chronic Hand Eczema (CHE) requires improved understanding of its etiological subtypes, signs and symptoms, and comorbidities. The objective of this study was to investigate the clinical characteristics of patients with moderate to severe CHE. METHODS: This was a multinational retrospective online chart review in Canada, France, Germany, Italy, Spain, and the UK. Physicians were asked to identify eligible patients from medical records to provide retrospective data over the past 12 months for up to 10 adult patients treated with topical corticosteroids (TCS) or for whom TCS were contraindicated. RESULTS: A total of 292 physicians completed forms for 1939 patients (56.8% with moderate and 43.2% with severe CHE). The most frequent etiological subtypes were irritant contact dermatitis (40.1%), atopic dermatitis (33.1%) and allergic contact dermatitis (27.5%). Palms (56.6%), fingertips (41.6%) and backs of hands (40.8%) were the most affected areas. Erythema and pruritus were the most frequent signs and symptoms. A history of atopic dermatitis was reported for 43.8% of patients. CONCLUSIONS: In conclusion, patients with moderate to severe CHE present with multiple etiological subtypes and a range of signs and symptoms. Many patients had no atopic condition besides CHE, and no history of atopic dermatitis, indicating that CHE is not simply atopic dermatitis of the hands.