Clinical Characteristics Of Hand Eczema In Yunnan And Observation Of Curative Effect Of Emollient Combined With

Objectives:Hand eczema(HE),a chronic recurrent disease with multiple causes,affects the work and life of patients seriously and also causes huge economic losses.The purpose of this study is to find the common allergens of hand eczema in this area,observe the effect of moisturizer combined with Halometasone/Triclosan cream on HE and finally provide guidance for clinical treatment through counting the population with high prevalence of HE in Yunnan as well as assessing the severity of the disease and the impact on the quality of life.Methods:Collecting 123 cases of Yunnan local patients diagnosed with hand eczema from October 2018 to September 2019 in our outpatient clinic,I inquired the patient's general information in detail and recorded the influencing factors,symptoms and signs of allergic disease history Eczema prevention and treatment measures,as well as the satisfaction with diagnosis,treatment and disease burden,also the impacts on patients' work and life,and carried out hand eczema severity and quality of life scores,improved the patch test and EOS count and total IgE examination and other related examinations,finally classiffied the patient's hand eczema.Then 123 patients were randomly divided into 2 groups,the control group with 61 cases and the experimental group with 62 cases.The control group was treated with Halomethasone/Triclosan cream.The experimental group was treated with emollient on the basis of the control group.Both groups received HESCI score and DLQI score before and after treatment.Results:(1)123 patients with HE,59 males and 64 females,with the age range of 44.97 ± 12.65,mostly are farmers and construction workers.15 patients have a history of allergies;about 1/3 patients have a disease course of more than 3 years and 1/2 patients Symptom duration are more than half a year.The Hand Eczema is pretty prevalent in summer.HE misdiagnosis rate is rather high(up to 39.02%)and the most common misdiagnosis is hand ringworm(up to 15.45%).The predominant places of HE are the palm and fingers.Endogenous keratotic HE was the most common,followed by mixed HE and ICD and CU/PCD is the last one.(2)The HECSI score in this area is concentrated on 0 to 11 points,and the symptoms are mostly mild(86.99%);the DLQI score is concentrated on 2 to 10 points(62.60%),and the impact on quality of life is mainly mild to moderate.The female's DLQI score is higher than men's.This difference is meaningful for patients'life and work,especially their discomfort symptoms.Since almost 1/5 patients choose to change or give up occupation,there is a weak positive correlation between HECSI score and DLQI score(rs=0.244).(3)The positive rate of the patch test in this study is 58.5%,male positive rate is lower than female.One type of allergens accounted for 19.51%,two types accounted for 13.82%,three types accounted for 13.01%,four types and more accounted for 12.20%.The most common allergens are cobalt chloride(15.45%),p-phenylenediamine(13.01%),kaba mixture(8.94%),nickel sulfate(8.13%);there are slight differences in gender,age,and occupational allergic substances,and the differences are not statistically significant.There is no correlation between the EOS count and total IgE(r?0.188);the differences in EOS count and total IgE in the positive result of patch test are meaningless.(4)The effective rate of the control group is 62.30%,and the effective rate of the experimental group is 79.03%which is significantly higher than that of the control group.The difference is statistically significant;The therapeutic index of the experimental group and the control group is also statistically significant.Conclusions:(1)The majority of patients with hand eczema in Yunnan are middle-aged and elderly,and most of them are farmers and construction workers.The skin lesions are mostly involved palms and scales is the main clinical symptoms.Endogenous keratotic HE is the most common type and CU/PCD is rare;HE is mostly mild patients,and has the mainly mild to moderate impact on quality of life;there is a weak correlation between the HECSI score and DLQI score;(2)The most common allergens in HE in this area are cobalt chloride,p-phenylenediamine,carba mixture,nickel sulfate;(3)There is no correlation between EOS count and total IgE;the difference in EOS count and total IgE in the positive result of patch test is meaningless;(4)Emollient combined with Halomethasone/Triclosan cream has a clear effect on HE and the use of emollient should be emphasized.