Chronic Hand Eczema Linked to Lost Productivity and Lower Quality of Life

Adults with chronic hand eczema (CHE) treated within the Duke University Health System reported substantial work productivity loss and reduced quality of life in a survey of 301 employed patients. The findings come from 2 posters presented at the 2026 Fall Clinical Dermatology Conference. Both analyses drew on the same cross-sectional survey, which was sponsored by LEO Pharma.^1,2

Nearly all patients in the survey were receiving routine care including topical corticosteroids (TCS), yet the occupational and psychosocial burden of CHE had not been well quantified in this setting. According to the authors, this is the first study to report quality of life and functional impairment among working adults with CHE treated at a large US health system.²

Between March and May 2026, patients with an ICD-10-CM code consistent with eczema or dermatitis (L20, L23, L24, L25, or L30) were invited to complete an online survey.¹ Eligible respondents were employed and reported hand or wrist eczema persisting for 3 months or longer or recurring at least twice in the past 12 months.^1,2 Respondents had a mean age of 38.5 years (SD, 12.3), 78.4% (236/301) were female, and 77.1% (232/301) worked full time.^1,2

Work productivity was measured with the Work Productivity and Activity Impairment (WPAI) questionnaire. Over the previous 7 days, patients reported 3.0% absenteeism, 30.9% presenteeism, and 31.8% overall work impairment attributable to CHE. Activity impairment was 21.9%.¹

On a scale of 0 to 10, 62.2% of patients reported some effect of CHE on work productivity and 66.4% reported some effect on daily activities. Severe impairment (score of 5–10) was reported by 14.1% (38/270) for work productivity and 16.3% (49/301) for daily activities. Overall, 11.0% had changed jobs or work roles because of CHE, and 13.6% reported missing 1 or more hours of work in the past week.¹

Occupational exposures were common. More than half of patients washed or sanitized their hands at least 10 times on a typical workday, and patients handled other potential irritants often (16.9%) or always (8.0%). In total, 42.2% perceived their CHE as caused or worsened by their workplace or occupation, as did 38.6% of patients with self-assessed moderate to very severe disease (n = 140).¹

Quality of Life Impairment on the DLQI and Hand Eczema Impact Scale

Quality of life was assessed with the Dermatology Life Quality Index (DLQI) and the Hand Eczema Impact Scale (HEIS), a disease-specific measure of functional impact. The mean DLQI total score was 6.7 (SD, 6.1) out of 30, and 21.9% of respondents reported a very large (11–20) or extremely large (21–30) effect on quality of life. The Symptoms and Feelings subscale showed the greatest impairment (mean, 2.6 [SD, 1.7] out of 6), followed by Daily Activities (mean, 1.4 [SD, 1.6]).²

The mean HEIS total score was 1.2 (SD, 0.9) out of 4. Domain scores were highest for Embarrassment (1.6; SD, 1.3), Frustration (1.6; SD, 1.2), and Proximal Daily Activity Limitations (1.4; SD, 1.0).²

Impairment increased with self-reported disease severity. Mean DLQI scores rose from 2.5 (SD, 2.8) among patients reporting clear skin to 14.2 (SD, 6.5) among those reporting very severe disease (P < .01). Mean HEIS scores followed the same pattern, increasing from 0.4 (SD, 0.4) to 2.3 (SD, 0.5) (P < .01).²

At the time of the survey, 53.0% reported clear or almost clear hands, 36.2% reported moderate disease, and 10.7% reported severe or very severe disease. When asked about their worst CHE in the previous 12 months, only 10% reported clear or almost clear skin.²

Topical therapy use was near universal (99.0%), and 71.8% had used only TCS. Among these TCS-only patients, 15.7% reported skin clearance after treatment. Mean DLQI was 2.8 (SD, 3.5) in patients reporting clearance and 8.4 (SD, 7.2) in those reporting no improvement (P = .0001).²

In the work productivity analysis, 95.7% (288/301) reported prior TCS use, and 52.8% of those patients had used TCS within the past week.¹ The authors concluded the findings emphasize the occupational burden of CHE, including reduced productivity, missed work, and job changes.¹ They also noted a substantial proportion of patients continued to have meaningful psychosocial and functional impairment despite extensive topical therapy and clear or almost clear skin at the time of the survey.²

Both analyses relied on self-reported severity, and no formal hypothesis testing was performed for the work productivity data.¹

Disclosure: LEO Pharma sponsored the study, and 4 of the 9 authors are employed by the company.^1,2

References

1. Weiss SC, Ozdemir S, Reed SD, et al. Impaired work productivity in adults with chronic hand eczema: a survey of patients in a large integrated healthcare system in the United States. Poster presented at: 2026 Fall Clinical Dermatology Conference; October 8–11, 2026; Las Vegas, NV
2. Weiss SC, Ozdemir S, Reed SD, et al. Quality of life and daily functioning impairment among working adults with chronic hand eczema in a large integrated healthcare system in the United States. Poster presented at: 2026 Fall Clinical Dermatology Conference; October 8–11, 2026; Las Vegas, NV