Prevalence, severity and predictors of hand eczema in patients treated for atopic dermatitis: a cross-sectional observational study

Background: Hand eczema (HE) is common among individuals with atopic dermatitis (AD), yet data on its prevalence and predictors in this population remain limited. Methods: 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). Results: 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. Conclusions: HE was highly prevalent in adult patients with AD treated in the dermatology setting, particularly among patients with moderate-severe AD.