Background
Hand eczema (HE) is common in health care workers (HCWs). During the last decade, new recommendations have supported increased use of alcohol‐based hand rub (ABHR) to partially replace ...hand washings to lower the prevalence of HE. However, newer data on this recommendation is lacking.
Objectives
To assess current 1‐year prevalence of HE in HCWs, to investigate exposure, and the extent of subjective discomfort to hand washings and ABHR.
Methods
A digital questionnaire was sent to 4876 HCWs from April to May 2020.
Results
Of 2125 respondents (1779 women, 346 men), 14.7% reported HE within the last year. In total, 9.1% reported >20 hand washings per shift and 76.0% reported ABHR use >20 times per shift. HE was significantly associated with hand washings (adjusted odds ratio OR 1.73 95% confidence interval CI 1.26‐2.36) and glove use on wet skin (adjusted OR 1.99 95% CI 1.27‐3.12). Subjective discomfort to ABHR was reported significantly more often than to hand washings (P < .001) and significantly more often in HCWs with HE than in those without HE (P < .001).
Conclusions
The current 1‐year HE prevalence in HCWs of 14.7% was lower than in previously reported Scandinavian data. HE was related to frequent hand washings, as previously reported, and to glove use on wet skin, which is a possible risk factor for HE that should be further explored.
The 1‐year prevalence of hand eczema (HE) was 14.7%, which is lower than previously reported.
HE was associated with frequent hand washings, as previously reported, and to glove use on wet skin, which is a possible risk factor for HE that should be further explored.
Subjective discomfort was reported significantly more often to alcohol‐based hand rubs than to hand washings and up to three times more often in health care workers with HE than in those without HE.
Background
It is recommended that patch test readings include a day (D)7 reading. Substitution of the D7 reading with a photo may be a valid option.
Objectives
To compare the sensitivity of digital ...photos at D7 to clinical readings, to assess the number of positive reactions appearing at D7 only (late reactions), and after D7 only (delayed reactions).
Methods
Patients patch tested in six European clinics were instructed to forward photos of the patch test reactions to the respective clinics at D7 (before attending the clinic) and at D21. Only allergens in the baseline series or TRUE Test were included in the data analysis.
Results
Two hundred ninety‐three of 629 patients had a total of 599 positive reactions, with 6.3% occurring at D7 only. When substituting the D7 reading with a photo (90% submitted), 26.3% of late reactions were missed and nine false‐positive reactions were found. Delayed reactions were detected in four patients at D21 (65.3% submitted).
Conclusion
Our data show that if the D7 reading is not performed, 6.3% of positive reactions from the baseline series would be missed, and if substituting the D7 reading by digital photo, 26.3% late reactions would be missed. Delayed reactions seemed rare.
Our data support the importance of a day (D)7 reading, since 6.3% late reactions were present at D7 only.
When the D7 reading was substituted with a photo, 26.3% of late reactions and 1.7% of all reactions were missed.
Forwarding a digital photo at D7 may be an opportunity for patients having difficulties with attending the clinical D7 reading.
Healthcare workers (HCWs) are considered a high‐risk group for developing hand eczema (HE), mainly owing to wet work and contact with allergens at work. To meta‐analyse the prevalence and incidence ...of HE in HCWs, as well as mapping the prevalence of atopic dermatitis (AD) and HE severity in HCWs. A systematic review and meta‐analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta‐analyses 2020 guidelines. Published literature from 2000 to 2022 was eligible based on predefined inclusion and exclusion criteria. A total of 18 studies were included. Pooled life‐time, 1‐year and point prevalence of self‐reported HE in HCWs was 33.4% (95% confidence interval CI: 28.3–38.6), 27.4% (95% CI: 19.3–36.5) and 13.5% (95% CI: 9.3–18.4), respectively. AD prevalence was 15.4% (95% CI: 11.3–19.9). Overall, the majority of HCWs reported mild HE. One included study assessed HE incidence reporting 34 cases/1000 person years. Most studies scored low‐moderate using the New Ottawa Scale and the pooled point prevalence data showed broad CIs. In conclusion, the high prevalence of HE in HCWs underlines the increased risk and need for preventive measures for this professional group. There is, however, a need of further standardized high‐quality studies.
Background
Alcohol‐based hand rub (ABHR) is recommended for hand hygiene, and application on dry skin is generally well tolerated. However, hydration of the skin may lead to increased susceptibility ...to ABHR.
Objectives
To evaluate if increased skin hydration changes skin barrier response to ABHR, as compared to application on dry skin.
Methods
Twenty healthy volunteers participated in a 3‐day experimental setup. Intervention areas on the forearms were exposed to either water immersion or occlusion followed by repeated exposures to ABHR. Skin barrier function was assessed by measurement of transepidermal water loss (TEWL), electrical conductance, pH, and erythema at baseline and day 3.
Results
The area exposed to water immersion preceding ABHR showed a significant increase in TEWL from baseline to day 3 (P = .04), and for the occluded area the same trend was found (P = .11), with an additional decrease in electrical conductance (P = .03). No significant differences were found for the control area. The assessments did not differ significantly between intervention and control sites.
Conclusion
Our results indicate that extensive skin hydration may lead to increased susceptibility to ABHR. Further evaluation of this observation is important, since ABHRs are widely used, particularly among health care workers in whom hand eczema is a huge problem.
The aim of this study was to investigate the early-life development of the skin microbiome in atopic dermatitis. Nineteen infants with atopic dermatitis and 19 healthy infants were evaluated 3 times, ...at 3 months intervals, within the first 30 months of life. Tape-strips were collected from volar forearms, cheeks, and eczema lesions, and the skin microbiome was assessed by 16S rRNA sequencing. Both the community structure and richness of the skin microbiome of infants with atopic dermatitis differed significantly from that of healthy infants, with greater richness in healthy infants. For infants with atopic dermatitis, the community composition was not dominated by Staphylococci. For healthy infants, community composition and richness correlated significantly with age, while such a pattern was not revealed in infants with atopic dermatitis. This suggests a slower maturation of the skin microbiome in atopic dermatitis, which precedes the staphylococcal predominance observed in older children and adults.
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This study set out to evaluate novel PCL-based silica containing nanohybrids as the polymer matrix in a hydrophobic drug-loaded microsphere system. Nanohybrids were synthesized by ...PCL-grafting to NH2-end grouped silica by in situ enzymatic ring opening polymerization of ε-caprolactone. Molecular weight and monomer conversion, PCL grafting percentage, thermal properties and crystallinity of the nanohybrids were determined by 1H NMR, TGA, DSC and XRD. Synthesized nanohybrids had low crystallinity percentage (32 and 39 %) and molecular weight (4800 and 8700 g/mol), promising for controlled drug release applications. The nanohybrids were used for fabrication of trans-chalcone-loaded microspheres by O/W single emulsion solvent evaporation. Mean particle diameter of the microspheres were between 15 and 30 µm. The result of release studies showed that optimum microsphere formulations (AP4 and A2, respectively) had 61 and 64 % encapsulation efficiency. One of the more significant findings to emerge from this investigation is that TC release was extended to 16 and 37 days, in a controlled manner. TC release was significantly enhanced in acidic pH media (pH 3.6 and 5.6) indicating pH-dependent release from nanohybrid microspheres; releasing 80–100 % of the loaded drug in 4–14 days. Drug/polymer interactions and molecular structures were investigated by FT-IR spectroscopy and DSC analysis. According to the results obtained, enzymatically synthesized nanohybrids have potential for pH-dependent release of the model drug, trans-chalcone.
•The Turkish version of the Geriatric Feelings of Burdensomeness Scale (T-GFBS) is a valid and reliable instrument for assessing feelings of burdensomeness in Turkish older adults.•The T-GFBS with 25 ...items and a single-factor structure was consistent with the original version.•The T-GFBS enables a comprehensive evaluation of feelings of burdensomeness in older adults.
The study aimed to evaluate the psychometric properties of the Turkish version of the Geriatric Feelings of Burdensomeness Scale (T-GFBS) in Turkish community-dwelling older adults.
This study included 300 community-dwelling older adults. Data were collected face-to-face between October 2023 and January 2024. The psychometric properties of the T-GFBS were evaluated using internal consistency, factor analysis, and test-retest reliability.
The confirmatory factor analysis indicated a good model fit (χ2/df = 2.360, RMSEA = 0.06, CFI = 0.93, GFI = 0.87, IFI = 0.93, TLI = 0.92). The scale revealed good internal consistency (Cronbach's alpha = 0.953) and acceptable test-retest reliability (ICC = 0.998). The single-factor structure of the T-GFBS with 25 items was consistent with the original version.
The T-GFBS is an easy-to-understand, comprehensive, reliable, and valid tool for assessing the feelings of burdensomeness in Turkish older adults.
Background
How changes in hand eczema (HE) severity correlate with the single scores on the Hand Eczema Severity Index (HECSI) is sparsely investigated and particularly needed in clinical trials.
...Objectives
To find the minimal important change (MIC) for HECSI based on patient's and physician's assessments using different methods.
Methods
In this prospective follow‐up study, three different anchors were used: two anchor questions for patients and physician, respectively, and the Physician Global Assessment (PGA) with a photographic guide. MIC was estimated by mean change in patients with a one‐step increase to anchor‐questions, receiver‐operating characteristic (ROC) plot, and smallest detectable change (SDC).
Results
One hundred fifty‐two patients with HE (63.8% female) were included at baseline (89% completed follow‐up). The mean change, ROC cutoff, and SDC values were 7.1, 4.5, 21.4 (patient‐rating), 8.2, 4.5, 8.3 (physician‐rating), and 16.6, 6.5, 27.1 points (PGA), respectively. SDC stratified by baseline severity was 2.9 and 11 points for mild and moderate‐severe HE (physician‐rating), respectively.
Conclusion
Identification of the MIC for the HECSI is important in relation to evaluation of treatment, intervention, and sample‐size calculations. An improvement of 8.3 points on the HECSI is recommended as the MIC. MIC values may differ according to baseline severity, and this variation should be clarified in future studies.
Highlights
The minimal important change (MIC) for the Hand Eczema Severity Index (HECSI) was 8.3 points, calculated by the smallest detectable change (SDC) using the physician‐rated anchor, since the Physician Global Assessment (PGA) was less sensitive and the HECSI is a physician‐rated tool.
When stratified by baseline severity, MIC values were 2.9 and 11 points for mild and moderate‐severe hand eczema, respectively.
Identifying the MIC for HECSI is important in relation to evaluation of treatment, intervention, and sample‐size calculations. MIC values may differ according to baseline severity, and this variation should be clarified in future studies.
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