A comparison between self‐reported hand eczema and self‐reported signs and symptoms of skin lesions indicating hand eczema

BACKGROUND: The accuracy of self‐reported hand eczema (HE) is currently unclear, and it is unknown how well self‐reported signs and symptoms of skin lesions that indicate HE correlate with self‐reported HE. OBJECTIVES: To correlate self‐reported signs and symptoms of skin lesions on the hands with self‐reported HE, to assess the sensitivity and specificity, and to suggest a definition for HE. METHOD: Seven hundred ninety‐five (47.8%) of 1663 invited healthcare workers completed a digital questionnaire, and were asked to report if they experienced HE or any of the following skin signs/symptoms in past 11 months: scaling, erythema, fissures, vesicles, dryness, itch, stinging. RESULTS: HE during the past 11 months was reported by 11.9%. Of these, 91.4% reported at least one skin sign versus 32.3% of those without self‐reported HE. The highest sensitivity and specificity were found for erythema (77.4% and 78.2%, respectively) and itch (78.5% and 78.6%, respectively), both separately and combined. The combination of ≥2 signs (erythema, scaling, fissures and vesicles) and itch, reached a sensitivity of 52.7% and specificity of 93.9%. CONCLUSION: The marked difference between self‐reported HE and signs/symptoms highlights the importance of differentiating between data based on self‐reported HE and signs/symptoms. As a first step towards diagnostic HE criteria, ≥2 signs combined with itch could be considered, but clinical studies are needed to verify the precision.