Obesity and Smoking contribute to severity of chronic hand eczema

Smoking and obesity were linked to chronic hand eczema (CHE) and hand eczema severity (HE) says an article published in Contact Dermatitis. With a growing emphasis in medicine on preventative and tailored treatment programmes, lifestyle behavior is becoming an important study issue in skin disorders. The relationship between lifestyle factors and HE was recently explored in a large cohort of the Dutch general population.

This study was conducted by L. Loman and team with an objective to investigate the relationship between lifestyle variables and HE in the same large cohort of the Dutch general population, but with a focus on the prevalence of CHE and severity of HE.

In this cross-sectional questionnaire study, the data from the Lifelines Cohort Study, a multi-disciplinary prospective population-based cohort study investigating the health and health-related behaviors of 169 729 people living in the north of the Netherlands.5 From 2006 to 2013, information on lifestyle factors was collected, and an additional questionnaire with questions about HE was sent out to all adults in 2020. In all, 58 198 individuals (42.8 percent) replied, with 57 046 of them being 18 years or older at the time of the survey and so included in the current study. The University Medical Center Groningen acquired institutional review board permission, and all individuals provided informed consent. Age, gender, atopic dermatitis (AD), and wet activities were all controlled for in the multivariate analysis. Statistical significance was defined as p-values less than 0.05.

The key findings of this study were as follow:

1. In the current study cohort, the 1-year prevalence of CHE was 4.6%.

2. In all, 7.4% of all participants with HE in the previous year reported having severe or very severe HE at worst in the previous year, resulting in a 0.5% 1-year prevalence of severe-to-very severe HE at worst in the previous year.

3. A multivariate study revealed a link between being female, having AD, participating in wet activities, and having CHE.

4. Furthermore, smoking, particularly smoking 8 cigarettes per day, a smoking history of 15 pack-years, stress, overweight and obesity, and a larger waist circumference were all related with developing CHE in the previous year.

5. In the previous year, age was found to have a negative relationship with CHE.

In conclusion, the ongoing effect of the lifestyle component, even after smoking cessation or weight loss, may influence the effect of lifestyle therapies on CHE and severity of HE. As a result, more study will be required to determine if secondary-prevention techniques in clinical practice are beneficial when advising patients with HE.

Reference: Loman, L, Politiek, K, Schuttelaar, MLA. Smoking and obesity are associated with chronic hand eczema and severity of hand eczema: Data from the Dutch general population. Contact Dermatitis. 2022; 1- 4. doi:10.1111/cod.14110