This information is intended for education of both the general public and healthcare professionals. If you are experiencing any symptoms please discuss the best treatment options with your doctor.

Diagnosis

Chronic Hand Eczema is hand eczema that lasts for more than 3 months, or relapses twice or more often in a year.¹

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Diagnostic guidelines

Diagnosing CHE

CHE is most commonly diagnosed through history taking and physical examination. Sometimes additional testing such as patch testing to detect contact allergies, skin prick testing, blood tests, medical biopsies or microbial testing may also be conducted.

According to the 2022 European Society of Contact Dermatitis (ESCD) guidelines, diagnosis should be based on:

A detailed history to assess the course of the disease, the elucidation of any potential triggers, and assessment of lifestyle factors:¹
- Current signs and symptoms
- Duration and course of disease
- Exacerbations and remissions in relation to work-related activities
- Personal and family history of atopic dermatitis
- Previous and concurrent skin or systemic diseases
- Regular use of medications
- Smoking habits
A clinical examination of the skin on hands and wrists¹
An exposure assessment to identify causal factors that may lead to a contact reaction¹
A diagnostic patch test, if feasible^1,2

Assessments

Along with clinical signs of Chronic Hand Eczema, it is important to measure subjective symptoms and quality of life (QoL) because Chronic Hand Eczema is a chronic disease which can have a high psychosocial burden.^1–3

Chronic Hand Eczema severity can be assessed using a range of tools that measure signs, symptoms, and health-related QoL.⁴

However, there is considerable heterogeneity in the outcome measures used to assess Chronic Hand Eczema, which makes data comparisons between studies difficult.⁴

In Clinical trials objective measures are reported by the investigator and assess the signs of Chronic Hand Eczema. These measures can be difficult to apply in clinical practice and no one system has been established. The foundational signs and symptoms of these measures are however assessed as part of history taking and physical examination.

Hand Eczema Severity Index (HECSI) is the most frequently used severity assessment tool for hand eczema.⁵

It is a validated outcome used to assess the signs of Chronic Hand Eczema. HECSI measures the intensity of six clinical signs on five areas of the hand on a four-point scale.⁶

In this regard, HECSI is similar to the Psoriasis Severity and Area Index used in psoriasis.⁷

Physician’s Global Assessment (PGA) scale measures the intensity of both the signs and symptoms of Chronic Hand Eczema.⁸

A severity classification from ‘clear’ to ‘severe’ is assigned based on the intensity of these features and the area affected.⁸

Investigator’s Global Assessment of Chronic Hand Eczema is a clinician-reported outcome developed by LEO Pharma.⁹

It measures the severity of Chronic Hand Eczema on a 5-point scale ranging from 0 (clear) to 4 (severe).⁹

Subjective measures are reported by the patient and provide insight into the signs of Chronic Hand Eczema, and the impact it has on their life:

Dermatology Life Quality Index is a QoL measure used across dermatological conditions.¹⁰

It consists of ten questions that measure the degree of impact a patient’s skin conditions has on different aspects of their QoL¹⁰

Hand Eczema Symptom Diary has been developed by LEO Pharma to specifically measure the severity of Chronic Hand Eczema symptoms over time.⁹

It measures six symptoms, including itch and pain, and scores their severity on an 11-point scale⁹

Hand Eczema Impact Scale is a Chronic Hand Eczema-specific assessment developed by LEO Pharma to measure the impact of Chronic Hand Eczema on QoL.⁹

It measures six domains: Proximal daily activity limitations, embarrassment regarding appearance of hands, frustration with Chronic Hand Eczema, sleep, work, and physical functioning⁹

This information is intended for education of both the general public and healthcare professionals. If you are experiencing any symptoms please discuss the best treatment options with your doctor.

Diagnosis

Chronic Hand Eczema is hand eczema that lasts for more than 3 months, or relapses twice or more often in a year.¹

Diagnostic guidelines

Diagnosing CHE

Assessments

Hand Eczema Severity Index (HECSI)

Physician’s Global Assessment (PGA)

Investigator’s Global Assessment of Chronic Hand Eczema (IGA-CHE)

Subjective measures are reported by the patient and provide insight into the signs of Chronic Hand Eczema, and the impact it has on their life:

Dermatology Life Quality Index (DLQI)

Hand Eczema Symptom Diary (HESD)

Hand Eczema Impact Scale (HEIS)

Related content

Chronic Hand Eczema overview

The burden of Chronic Hand Eczema

Understanding Chronic Hand Eczema

References

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This information is intended for education of both the general public and healthcare professionals. If you are experiencing any symptoms please discuss the best treatment options with your doctor.

Diagnosis

Chronic Hand Eczema is hand eczema that lasts for more than 3 months, or relapses twice or more often in a year.1

Diagnostic guidelines

Diagnosing CHE

Assessments

Hand Eczema Severity Index (HECSI)

Physician’s Global Assessment (PGA)

Investigator’s Global Assessment of Chronic Hand Eczema (IGA-CHE)

Subjective measures are reported by the patient and provide insight into the signs of Chronic Hand Eczema, and the impact it has on their life:

Dermatology Life Quality Index (DLQI)

Hand Eczema Symptom Diary (HESD)

Hand Eczema Impact Scale (HEIS)

Related content

Chronic Hand Eczema overview

The burden of Chronic Hand Eczema

Understanding Chronic Hand Eczema

References

Chronic Hand Eczema is hand eczema that lasts for more than 3 months, or relapses twice or more often in a year.¹