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Occupational hand eczema (OHE) is the most frequently recognized occupational disease in Denmark, and despite governmental attempts to reduce exposure to harmful occupational allergens, the number of new cases has remained almost unchanged since the mid-1990s. Some studies have indicated that OHE has considerable impact on quality of life (QoL) and may lead to depression. The aims of the study were to determine risk factors for low QoL, the frequency and severity of depression among OHE patients and changes in QoL and depression after 12 months of follow up. The study population, 758 patients, comprised all new recognized cases from the Danish National Board of Industrial Injuries Registry between October 2001 and November 2002. All patients received a questionnaire to determine impairment of QoL and depressive symptoms. A similar follow-up questionnaire was posted after 1 year. The response rate was 82% at baseline and 91% at follow up. The mean Dermatology Life Quality Index total score was 5.5 for all patients and 7.8 for severe OHE cases. Severe OHE cases and lower socioeconomic status were independently associated with low QoL. The prevalence of moderate-to-severe depression was 9%. Only minor changes in QoL and depressive symptoms were found after 12 months of follow up.
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PMID:Quality of life and depression in a population of occupational hand eczema patients. 1648 83

The misery of living with atopic eczema (syn. dermatitis, AD) cannot be overstated for it may have a profoundly negative effect on the health-related quality of life (HRQoL) of children and their family unit in many cases. As it is one of the commonest chronic relapsing childhood dermatosis (UK lifetime prevalence 16-20% by 20 years), with increasing worldwide prevalence, this has major social and financial implications for individuals, healthcare providers and society as a whole. This review explores the impact of AD on the lives of children and their family units and the use of some of the recently developed HRQoL measures, which have enabled investigation and categorisation of the physical, psychological and psycho-social effects of childhood eczema across all aspects of life. These effects include symptoms of itching and soreness, which cause sleeplessness in over 60%. Sleep deprivation leads to tiredness, mood changes and impaired psychosocial functioning of the child and family, particularly at school and work. Embarrassment, comments, teasing and bullying frequently cause social isolation and may lead to depression or school avoidance. The child's lifestyle is often limited, particularly in respect to clothing, holidays, staying with friends, owning pets, swimming or the ability to play or do sports. Restriction of normal family life, difficulties with complicated treatment regimes and increased work in caring for a child with eczema lead to parental exhaustion and feelings of hopelessness, guilt, anger and depression. The hidden costs involved in eczema management can be significant and have particular impact on lower income families. The impairment of quality of life caused by childhood eczema has been shown to be greater than or equal to other common childhood diseases such as asthma and diabetes, emphasising the importance of eczema as a major chronic childhood disease. HRQoL measures are proving to be valuable tools for use in the clinical setting, as outcome measures for pharmaceutical studies, for health economics and audit purposes. It is therefore recommended that in future, they should be used in conjunction with objective measures of severity, as part of the assessment process of a child with atopic eczema. Lack of information on eczema and treatments heightens parental anxiety. Education of all individuals involved in the care of children with eczema is fundamental in the management of AD and it is essential to provide simple clear, unambiguous information on treatment and disease management in order to reduce the negative impact on HRQoL.
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PMID:Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. 1689 32

In this paper, the relation between psychological factors and psychiatric disorders in patients with skin diseases is discussed. On the one hand psychological factors (stress, negative emotions) can influence the generation and aggravation of skin disorders (urticaria, atopic dermatitis, vitiligo), on the other hand psychological disorders can result in some skin diseases (psoriasis, atopic dermatitis). In the majority of cases the quality of life is poorly estimated by patients with skin problems. Psychodermatology is divided into three categories according to the relationship between skin diseases and mental disorders: 1) psychophysiologic disorders caused by skin diseases triggering different emotional states (stress), but not directly combined with mental disorders (psoriasis, eczema); 2) primary psychiatric disorders responsible for self-induced skin disorders (trichotillomania); and 3) secondary psychiatric disorders caused by disfiguring skin (ichthyosis, acne conglobata, vitiligo), which can lead to states of fear, depression or suicidal thoughts.
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PMID:[The role of psychological factors and psychiatric disorders in skin diseases]. 1753 93

Twenty nail dystrophy (TND) trachyonychia, a fascinating clinical condition, was brought to focus 25 years ago. Ever since, it has been sparingly reported. Nonetheless, the condition is well-recognized and its diagnosis is made on the basis of clinical features characterized by onset in infancy/childhood, and occasionally in adults. The lesions are fairly representative, and are characterized by the alternating elevation and depression (ridging) and/or pitting, lack of luster, roughening likened to sandpaper, splitting, and change to a muddy grayish-white color. Dystrophy is prominent. Several modes of occurrence have been described including an hereditary component. The confirmation of diagnosis is through microscopic pathology corresponding either to endogenous eczema/dermatitis, lichen-planus like or psoriasic-form. It is a self-limiting condition and may occasionally require intervention.
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PMID:Twenty nail dystrophy trachyonychia: an overview. 1753

Four cases treated with Aurum muriaticum natronatum are presented using the patients' own words; two cases of fibromyoma of uterus and thyroid disorders, and two of eczema and depression with suicidal ideation after disappointed romantic love. The case analyses and management are discussed and distilled into the materia medica of Aurum muriaticum natronatum with the creation of a heuristic.
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PMID:Aurum muriaticum natronatum--four case reports. 1795 84

There are multiple reports of increased prevalence of anxiety and depression in patients with asthma, eczema and rhinitis. Suggested biological mechanisms underlying these associations most commonly involve IgE. However, the association between anxiety/depression and IgE has hardly been studied, and the aim of the present study will therefore be to examine the hypothesized association between anxiety/depression and IgE in a general adult female population. A sub-sample of 374 female participants in a population-based general health study in Norway (the Hordaland Health Study) with participation rate 70% was screened for total and allergen-specific IgE. Anxiety and depression were measured employing the Hospital Anxiety and Depression Scale (HADS). This design ensured adequate statistical power, and the population-approach ensured satisfactory variance in both IgE and anxiety/depression. No association between case level or symptom load of anxiety/depression and total or allergen-specific IgE was found. Non-significant tendencies were both positive and negative. This finding was robust across continuous and categorical statistical approaches. Our finding does not question the commonly reported associations between anxiety/depression and asthma, rhinitis and eczema. We do, however, question the relevance of IgE as an aetiological factor in the biological chain underlying these associations.
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PMID:There are no association between IgE levels and symptoms of anxiety and depression in the adult female general population. The Hordaland Health Study (HUSK). 1823 6

18 chronic diseases were investigated in a population of 13,115 women living in six settings of West- (Avon UK, the Isle of Man), Central- (the Czech Republic and the Slovak Republic) and East-Europe (the Ukraine and Russia), that collaborate in the European Longitudinal Study of Pregnancy and Childhood (ELSPAC project). In prenatal questionnaires filled in after the first half of pregnancy, women reported 25,795 chronic diseases they ever suffered, out of them 11,188 having in present pregnancies. In the whole sample, lifelong prevalence was 11,2%, and prevalence in pregnancy 4,8% which means that 43,4% of all chronic diseases recurred in pregnancy. Up to mean age of 255 years in the whole sample, 39,6% women reported ever having indigestion, 29% back pains, 22,6% migraine, about 16% haemorrhoids, hay fever and eczema, about 10% varicose veins, anorexia nervosa, heavy depression and kidney diseases, over 5% rheumatism and 4% asthma. Less prevalent were infections of pelvic organs, febrile convulsions, joint inflammations, stomach ulcers, psoriasis and epilepsy. Lifetime prevalence of chronic diseases and their prevalence in pregnancy were the highest in the western zone and decreased eastwards, but recurrence grew in the opposite direction, being the highest in the eastern zone. The variation of each morbidity indicator is followed in all diseases between geographical zones as well as between individual study centres.
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PMID:Chronic morbidity in women, namely in pregnancy. (Comparative study between West, Central and East European centres). 1882 44

Hand eczema is a common condition in the industrialized world and the most common occupational skin disorder. The economic impact of hand eczema is daunting, with both direct and indirect costs. The former include medical costs, as well as costs associated with disability, workers' compensation, and rehabilitation, while the latter include absence from work, loss of productivity, job changes, and even job loss. Individuals with more severe, recurrent, or protracted hand eczema can endure serious psychosocial repercussions and a substantially impaired quality of life (QOL). In some cases, hand eczema adversely affects patients' social lives. Individuals with hand eczema also may experience emotional distress, including depression, mood disorders, and disrupted sleep. Because of these potentially deleterious economic and psychosocial consequences, hand eczema should be regarded as an important public health challenge.
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PMID:Chronic hand eczema: a prevalent and challenging skin condition. 1920 70

Atopic dermatitis is a common, chronic skin disease characterized by dry, itchy and easily irritated skin. It occurs most commonly in infants and young children, but can persist into adulthood. Severe cases can lead to sleep deprivation, chronic bacterial infections, and depression. Along with other allergic diseases, its prevalence has grown significantly in recent years. Topical medicines are the most common and effective treatment for atopic dermatitis. Drugs taken orally and used to suppress the immune system have been converted into an ointment or cream. These topical immunosuppressive agents are being used now to treat eczema. Advantan (0.1% methylprednisolone aceponate) is indicated for the treatment of eczema and other inflammatory skin disorders as a highly effective topical corticosteroid. The effect of Advantan in the treatment of atopic dermatitis was studied. A clinical study of Advantan ointment involved 26 patients aged between 6 and 56 years with atopic dermatitis. Positive therapeutic effect was achieved in the overwhelming majority of the patients (n=25). It was concluded that Advantan ointment produced by Schering AC had marked antiinflammatory and antipruritic action. It was convenient to use and well tolerated by the patients. It is concluded that Advantan may be used for the treatment of patients with atopic dermatitis.
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PMID:[Advantan for therapy of atopic dermatitis]. 1957 9

How might the psycho-social effects of chronic skin disease, its treatments (and discontents) be figuratively expressed in writing and painting? Does the art reveal common denominators in experience and representation? If so, how do we understand the cryptic language of these expressions? By examining the works of artists with chronic skin diseases--John Updike, Elizabeth Bishop, and Zelda Fitzgerald--some common features can be noted. Chronically broken skin can fracture the ego or self-perception, resulting in a disturbed body image, which leads to personality disorders and co-morbid affective disorders such as anxiety and depression. The vertiginous feeling that results can be noted in the paradoxical characters, figures, and psyches portrayed in the works of these artists. This essay will examine the more specific ways in which artists disclose and/or conceal their experiences and the particular ways in which these manifest in their works. While certain nuances exist, the common denominators give us a starting point for developing an eczema aesthetic, a code for interpreting the ways in which artists' experiences with skin disease manifest in their works.
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PMID:Drawing the eczema aesthetic: the psychological effects of chronic skin disease as depicted in the works of John Updike, Elizabeth Bishop, and Zelda Fitzgerald. 2018 66


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