Smoking and Obesity Associated with Chronic Hand Eczema

Marie-Louise Schuttelaar, MD, PhD

A new cross-sectional study found that smoking and obesity were associated with both chronic hand eczema (CHE) and the severity of hand eczema.

In recent years, the subject of lifestyle behavior has become a increasingly important across various preventive and personalized treatment programs, with several studies reporting on the association between lifestyle factors and hand eczema.

Despite this, a small number of those previous studies incorporated the severity of hand eczema as an outcome measure, and even less focused specifically on CHE.

As such, a team of investigators led by, Marie-Louise Schuttelaar, MD, PhD, Department of Dermatology at the University of Groningen, assessed the dynamic between lifestyle factors and hand eczema from an early, large sample of the Dutch general populationwith an additional focus on the prevalence of CHE and severity of hand eczema.

The questionnaire-based study utilized data from the multi-disciplinary prospective population-based cohort study, the Lifelines Cohort Study.

The Lifelines Cohort Study examined the health and health-related behaviors of 169,729 individuals living in the North of the Netherlands. Information on lifestyle factors from 2006-2013 was collected along with data from an additional questionnaire featuring questions regarding hand eczema.

The questionnaire was sent to a total of 135, 950 adults, 58,198 of whom responded and 57,046 of whom were included in the analysis.

From there, binary logistic regression models were performed with CHE in the past year compared to no history of hand eczema, as well as severe-to-very severe hand eczema versus almost clear-to-moderate hand eczema in the past year as the dependent variables.

Multivariate analysis were adjusted for age, sex, atopic dermatitis, and wet activities, and P-Values of <0.05 were considered to be statistically significant.

Overall, investigators observed that the 1-year prevalence of CHE in the study population was 4.6%, and a total of 7.4% of all subjects with hand eczema in the past year reported severe or very severe hand eczema. This resulted in a 1-year prevalence of severe-to-very severe hand eczema at worst in the past year.

A multivariate analysis found positive associations between CHE and atopic dermatitis, as well as being female and exposure to wet activities.

Additionally, smoking (particularly 8 cigarettes a day), a 15 year or less history of smoking, stress, overweight and obesity, and a higher waist circumference were all positively associated with CHE at baseline.

Conversely, age was shown to have a negative association, as did the highest category of physical activity.

Regarding counseling for patients with hand eczema, investigators suggested further research would be needed to evaluate the effectiveness of secondary-prevention strategies in clinical practice.

“Replication of these results in an independent cohort will be important to support these findings,” the investigators wrote. “Ideally, future research should include the evaluation of the effect of lifestyle interventions in daily practice.”

The study, "Smoking and obesity are associated with chronic hand eczema and severity of hand eczema: Data from the Dutch general population," was published online in Contact Dermatitis.