RESUMEN
BACKGROUND: There is a need for a standardized clinical grading system for a more objective and accurate assessment of the severity of hand eczema (HE). OBJECTIVES: To develop and validate a scoring system called the hand eczema severity index (HECSI) designed for clinical assessment of HE. METHODS: Twelve dermatologists (observers) assessed 15 HE patients twice, with an interval of 30 min. The study was performed blinded for the observers, and only the hands and wrists of the patients were visible to the observers. Agreement between the observers was determined by using the intraclass correlation coefficient (ICC), which is the correlation between (single) ratings of the same patient. RESULTS: ICC for total HECSI score was 0.79 at the first assessment and 0.84 at the second assessment. ICC for intraobserver agreement was 0.90. CONCLUSIONS: Overall excellent agreement existed for both inter- and intraobserver reliability and the scoring system is suggested for use in future clinical studies on HE. Because HECSI is an entirely objective assessment of clinical signs, in addition, inclusion of patient-rated symptoms should be considered.
Asunto(s)
Eccema/patología , Dermatosis de la Mano/patología , Índice de Severidad de la Enfermedad , Adolescente , Adulto , Anciano , Eccema/complicaciones , Femenino , Dermatosis de la Mano/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Método Simple CiegoRESUMEN
Quality of life (QoL) assessment has rapidly become an important outcome variable in dermatology research. Even though the importance of the patient's personal morbidity is generally accepted as being important by dermatologists, scepticism and confusion remain about the usefulness of QoL in dermatological research and how it should be measured. QoL assessments in individuals with contact dermatitis are few. A structured review of the literature is presented. All studies reviewed found that contact dermatitis is associated with impaired health-related QoL. Hand eczema appears to be as equally impairing as generalized eczema and an early, confirmed diagnosis is associated with improved QoL. Disease duration, atopic dermatitis, age and gender do not seem to have a major impact on QoL, although contradictory findings exist. Assessment of QoL in contact dermatitis is required for future clinical research and may be a valuable tool to the clinician to evaluate new treatments. A combination of dermatology-specific (e.g. Dermatology Life Quality Index) and generic questionnaires (e.g. the Short Form-36) is supported.