Chronic Hand Eczema Linked to Multifactorial Triggers, QOL Burden

New data from the CHECK-US study are providing a more complete picture of chronic hand eczema (CHE), revealing the diverse factors patients believe drive their disease and the substantial impact it has on daily life. The findings, presented across 2 posters at the 2026 American Academy of Dermatology (AAD) Annual Meeting, underscore the need for more personalized, patient-centered management strategies.^1,2

Taken together, the 2 analyses offer complementary insights: one highlights how patients perceive the causes of their disease, while the other quantifies its real-world impact.

The trigger-focused findings emphasize the multifactorial nature of CHE, while the health-related quality of life (HRQOL) data illustrate how these factors translate into meaningful disruptions in daily life. Importantly, both sets of findings reinforce that CHE is not solely a physical condition but one that also carries significant psychological and functional consequences.

“The patient contribution to the development of a nuanced understanding of CHE triggers is essential for guiding patient-centered management and tailoring individual prevention or treatment strategies,” wrote the authors of one of the posters.

One poster focused on patient-reported triggers of CHE, analyzing responses from 982 US adults with a self-reported physician diagnosis. The findings highlight the complexity of the condition, with most patients identifying multiple contributing factors rather than a single cause.¹

Environmental triggers emerged as the most commonly reported, cited by 69.4% of participants. These included frequent hand washing, exposure to water, chemical irritants, contact allergens, and even protective gloves used in occupational settings. Biological factors, such as genetic predisposition and immune dysfunction, were reported by nearly half (47.4%) of patients, while psychological triggers, including stress and emotional factors, were identified by one-third (34.1%). Lifestyle-related contributors, such as smoking, alcohol use, and diet, were reported by 26% of patients.

When asked to identify a single primary trigger, environmental factors again ranked highest, followed by genetic predisposition and psychological stress. These findings suggest that while CHE is often driven by overlapping influences, patients tend to attribute their disease to one dominant factor, noted the poster authors.

The trigger-focused analysis also revealed demographic differences. Women were more likely than men to report environmental (73.4% and 66.1%, respectively; P = .02) and psychological (47.5% and 22.8%, respectively; P < .01) triggers, while men more frequently identified lifestyle factors (29.7% and 21.7%, respectively; P < .01) and infections (19.1% and 10.9%, respectively; P < .01). Employment status and urban living were also associated with higher reporting of lifestyle-related triggers, reflecting potential exposure patterns.

A second poster examined the HRQOL burden of CHE using validated patient-reported outcome measures. Using the same cohort of 982 participants, this analysis demonstrated that CHE significantly affects both physical functioning and emotional well-being.²

Nearly two-thirds of patients (65.1%) reported moderate to severe disease in the week prior to the survey, highlighting the ongoing severity of symptoms in a large portion of patients. Across the cohort, the average Dermatology Life Quality Index (DLQI) score was 10.6, indicating a moderate overall impact on daily life. Additional measures from the Hand Eczema Impact Scale (HEIS) showed meaningful impairment across multiple domains, including physical activity, work, sleep, and emotional well-being.

Patients reported difficulty with everyday tasks such as washing, using cleaning products, gripping objects, and performing work-related activities. Emotional impacts, such as embarrassment about the appearance of hands and frustration with persistent symptoms, were also common.

Treatment patterns further contextualized these findings. Approximately 39.1% of participants were receiving systemic therapies or phototherapy, while 31.8% were treated with topical corticosteroids (TCS) alone. Notably, 19.1% reported receiving no treatment.

Patients treated with TCS alone reported lower HRQOL burden compared with those receiving systemic therapies, likely reflecting differences in disease severity. Within the TCS group, quality-of-life scores worsened significantly as disease severity increased, reinforcing the relationship between clinical severity and patient experience.

References

1. Simpson E, Balu S, Sawad AB, et al. Patient-perceived factors associated with Chronic Hand Eczema – results from the CHECK study in the United States. Presented at: 2026 AAD Annual Meeting; March 27-31, 2026; Denver, CO. Poster 78486.

2. Chovatiya R, Balu S, Sawad AB, et al. Health-related quality of life in people with Chronic Hand Eczema - results from the CHECK study in the United States. Presented at: 2026 AAD Annual Meeting; March 27-31, 2026; Denver, CO. Poster 74798.