| アブストラクト | BACKGROUND: The self-reported annual prevalence of hand eczema (HE) in adults is about 10%. Incidence and prevalence data for HE, chronic HE (CHE) and steroid-refractory CHE (SR-CHE) in physician-attended populations are lacking. OBJECTIVES: To estimate the prevalences of HE, CHE and SR-CHE in a primary-care population using a cross-sectional design; and to estimate the incidence of each and describe initial therapy using a cohort approach. METHODS: The population was all patients in the Clinical Practice Research Datalink for 2000-10, 2005-10 and 2010-11. HE was defined as any of 12 diagnoses (six specific to the hand, six for contact dermatitis). HE became CHE if any of these 12, or three additional diagnoses, occurred 90-365 days after the first HE, and if the patient was prescribed at least one course of potent topical steroids. A patient with CHE was classified as having SR-CHE if they were (i) referred to a dermatologist and/or (ii) prescribed phototherapy, systemic immunomodulators, oral corticosteroids, alitretinoin or acitretin. RESULTS: The 1-year adult prevalence of HE was 0.4%. The period prevalences of SR-CHE for 1, 5 and 10 years in adults were 0.008%, 0.036% and 0.072%, respectively; lifetime estimates were 0.071%, 0.080%, 0.098%. About one-half of cases of CHE were steroid refractory. All conditions were more common in female than in male patients. One-third of HE diagnoses were specific for the hand, the remainder were for contact dermatitis. The majority (62%) of newly diagnosed patients with HE were not prescribed treatment in the 12 months after diagnosis. CONCLUSIONS: Although the prevalence of HE could be 2-3 times higher than reported herein, the proportion of adults seeking medical care for HE is a fraction of those who self-report HE. SR-CHE is rare. |
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| ジャーナル名 | The British journal of dermatology |
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| 投稿日 | 2016/08/19 |
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| 投稿者 | Crane, M M; Webb, D J; Watson, E; Cunliffe, T; English, J |
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| 組織名 | GlaxoSmithKline, Research Triangle Park, NC, U.S.A.;Consultant epidemiologist, Chapel Hill, NC, U.S.A.;GlaxoSmithKline, Stockley Park, U.K.;South Tees Hospitals NHS Foundation Trust, Northallerton, U.K.;Nottingham University Hospitals NHS Trust, Nottingham, U.K. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/27534443/ |
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