Patients can accurately self-assess eczema on their hands
MedWire News: A study has found that patients with eczema can accurately score the extent of the condition on their hands without the help of healthcare professionals.
There was good agreement in terms of hand eczema scoring between dermatologists and nurses as well as between dermatologists and patients themselves.
"In the future it may be an option to use patients' own assessment as an inexpensive and informative source of follow-up information in the clinic," say the team of researchers led by Åke Svensson from Lund University in Malmö, Sweden.
The prognosis of hand eczema is poor, with patients often suffering long episodes and relapses of the condition.
Making an assessment of the current extent of hand eczema can be an important part of patient care, giving dermatologists an important indication of how patients are responding to treatment. A number of scoring systems have been developed to help with this, although so far they have only been used in clinical studies.
Svensson and team assessed whether patients could assess their own condition on their hands using the scoring system of Meding and Swanbeck, which is based on dividing the hand into discrete areas.
Altogether 62 patients participated in the study and overall there was good agreement between patients' self-scores and dermatologists' scores. In addition there was good agreement between dermatologists and nurses, providing further confidence in the scoring system.
"In our investigation the patients were able to understand the written instructions, and the diagrams in the assessment form functioned well," Svensson and colleagues comment.
Patients tended to be more accurate in their assessment of their fingertips and nails than dermatologists, but less accurate for the palm and dorsum of the hand, perhaps because the boundaries of some areas are more easily defined than others for scoring.
"In most health care systems there is time pressure on the doctor which can negatively affect the provision of adequate information for patients," Svensson and team comment.
They add: "The scoring instrument studied here for use both by the dermatological nurse and by the patient with hand eczema could be a valuable contribution to patient education, compliance and documentation in the field of hand eczema."
The research was published in the British Journal of Dermatology.
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By Andrew Czyzewski