Chronic Hand Eczema

For Members:

What is Chronic Hand Eczema?

hand eczema (HE), is inflammatory skin disease that strongly impacts the quality of life of affected individuals. HE should be considered an umbrella term as it covers different aetiologies and morphologies. Chronic HE (CHE) refers to Hand Eczema that lasts for more than 3 months or relapses twice or more often per year. The most 2 common symptoms are itch & pain.

Chronic Hand Eczema (CHE) signs and symptoms vary widely from person to person and include:

• Itch & Pain are the two most common symptoms.

• Among the primary acute lesions that may be observed are erythema, oedema, oozing, crusting, papules, and vesicles/bullae.
• Secondary chronic lesions include lichenification, hyperkeratosis, scaling, and fissures.

Chronic hand eczema is a heterogenous inflammatory skin disorder. Risk factors often associated with HE includes atopic dermatitis (AD) in childhood, being contact allergic, being exposed to wet work, cold/dry weather conditions, and decreased indoor humidity as well as being active in certain occupations.

Prevention

The following tips may help prevent bouts of dermatitis (flares) and minimize the drying effects of bathing:

• Offering health education and training to individuals in high-risk groups.
• Seek knowledge of endogenous and other individual risk factors should also be considered.
• Using protective gloves, and emollients to eliminate substances that do irritation or allergy.
• If complete elimination of exposure to hazardous substances is not possible, personal protective equipment (PPE) should be utilized after careful selection.
• Examples of PPE:
  • Protective gloves should be intact, clean and dry inside.
  • Hand washing is important to remove hazardous substances from the skin.
  • Apply emollients on your hands during the working day.
  • Do not wear rings or any other jewellery on the hands when performing wet work.

When to see a doctor?

You need to see a doctor if you experience any changes in the skin of your hand like dryness, cracking, or erythema.

For Healthcare Providers:

• Moderate to severe Chronic Hand Eczema is a chronic heterogeneous inflammatory skin disease linked to endogenous and exogenous factors.
• Improvement in Chronic Hand Eczema lesions can be visible after a variable period of treatment with:

• •  Topical steroids (short-term treatment), Topical calcineurin inhibitors.
  • Oral Alitretinoin, or systemic biologics like Dupilumab.

• Pre-approval is required for treatment with any of the FDA approved biologic medications.
• Chronic Hand Eczema form is required for pre-approval, click here to download the form.

Please use the below ICD codes:

References:

https://onlinelibrary.wiley.com/doi/epdf/10.1111/cod.14035

https://pubmed.ncbi.nlm.nih.gov/21084020/ company

S2k guideline diagnosis, prevention, and therapy of hand eczema – PubMed (nih.gov)

Hand Eczema | About and Treatments | Eczema.org