Prevalence of Chronic Hand Eczema in adults: A cross-sectional survey of over 60,000 respondents in the general population in Canada, France, Germany, Italy, Spain, and the United Kingdom

Abstract Background The lack of attention to Chronic Hand Eczema (CHE) and the lack of a specific International Classification of Diseases code for CHE may have limited the assessment of CHE prevalence. To date, prevalence estimates have primarily been derived from (partly small) single-country studies. Objectives To estimate the annual prevalence of self-reported physician-diagnosed CHE across socio-demographic characteristics among adults in Canada, France, Germany, Italy, Spain, and the United Kingdom (UK). Methods In this observational Chronic Hand Eczema epidemiology, Care, and Knowledge of real-life burden (CHECK) study, a questionnaire was administered to adults between 18 and 69 years old in the general population, recruited through online panels. Quotas and minor weighting adjustments were performed to ensure that the participants were representative of the general population regarding sex, age, region, employment status, urban/rural setting, and, in the UK only, ethnicity. Additional weights were applied to account for population size differences when aggregating country results. Information on self-reported physician-diagnosed CHE was collected. CHE was defined, in accordance with the European Society of Contact Dermatitis, as having hand eczema continuously for three months or more or at least two flares in the past 12 months. CHE annual prevalence with 95% confidence intervals (CIs) was determined for each country, and by subgroups of sex, age, employment, and urban/rural. Results Among 60,131 participants, 2,847 self-reported physician-diagnosed CHE, yielding an annual prevalence of 4.7% (CI: 4.6-4.9). Subgroup analyses revealed the CHE prevalence was significantly higher in females than males (5.6% [5.4-5.9] vs. 3.8% [3.6-4.1]; P<0.001), in employed versus unemployed participants (5.3% [5.1-5.6] vs. 3.3% [3.1-3.6]; P<0.001), and in urban versus rural residents (5.0% [4.8-5.2] vs. 3.7% [3.4-4.1]; P<0.001). The prevalence was highest among those aged 30-39 years (6.5% [6.0-7.0]) and lowest in those aged 60-69 years (2.6% [2.3-3.0]). Conclusions This large multi-national study is the first to assess CHE prevalence in Europe and Canada using a consistent definition across a broad geographical population. This study reveals that CHE is a common skin disease with annual prevalence of 4.7%, with higher prevalence among females, individuals aged 30-39, those employed, and those living in urban areas.