Chronic hand eczema in Germany: 5-year follow-up data from the CARPE registry

Contact Dermatitis. 2019 Jan;80(1):45-53. doi: 10.1111/cod.13113. Epub 2018 Sep 24.

Abstract

Background: The CARPE registry was set up in 2009 to prospectively investigate the management of patients with chronic hand eczema (CHE).

Objectives: To report comprehensive follow-up data from the CARPE registry.

Patients and methods: We investigated sociodemographic and clinical characteristics, provision of medical care, physician-assessed outcomes, and patient-reported outcomes (PROs). Data were collected between 2009 and 2016, with up to 5 years of follow-up, and are reported descriptively.

Results: Overall, 1281 patients were included in the registry (53.7% female). Mean age was 47.0 years. Of the patients, 793 and 231 completed the 2-year follow-up and 5-year follow-up, respectively. At baseline, 5.4% had changed or given up their job because of CHE, the average duration of CHE was 6.1 years, and, in 22.4%, the CHE was severe according to physician global assessment. Systemic treatment (alitretinoin, acitretin, and methotrexate) was prescribed at least once to 39.0% of the patients during the course of the follow-up. Disease severity, quality of life and treatment satisfaction improved over time, and the proportion of patients receiving systemic treatments decreased.

Conclusions: Under continued dermatological care, substantial improvements in disease severity and PROs over time was achieved during the course of the CARPE registry, even in patients with long-standing and severe hand eczema.

Keywords: hand eczema; quality of life; registry; treatment.

MeSH terms

  • Acitretin / therapeutic use
  • Administration, Cutaneous
  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Alitretinoin / therapeutic use
  • Chronic Disease
  • Dermatitis, Allergic Contact / etiology
  • Dermatitis, Allergic Contact / physiopathology*
  • Dermatitis, Allergic Contact / therapy
  • Dermatologic Agents / therapeutic use
  • Eczema / physiopathology
  • Female
  • Follow-Up Studies
  • Hand Dermatoses / physiopathology*
  • Hand Dermatoses / therapy
  • Humans
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Outcome Assessment, Health Care
  • PUVA Therapy
  • Patient Reported Outcome Measures
  • Registries*
  • Ultraviolet Therapy
  • Urea / therapeutic use
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Dermatologic Agents
  • Alitretinoin
  • Urea
  • Acitretin
  • Methotrexate