Scoring of hand eczema: good agreement between patients and dermatological staff



This article is corrected by:

  1. Errata: Corrigendum Volume 167, Issue 6, 1400, Article first published online: 26 November 2012

  • Funding sources
    Edward Welander and Finsen Foundations, the Swedish Dermatological and Venereological Nursing Association and the Swedish Society of Nursing.

  • Conflicts of interest
    None declared.

Åke Svensson.


Background  Assessment of hand eczema in a clinical study has been achieved using a scoring system which documents extent of eczema on different areas of the hand.

Objectives  To investigate whether the same scoring system could be used by patients to communicate current status of hand eczema.

Methods  In a study of 62 patients (36 women and 26 men, age range 19–75 years), the patient’s own assessment was compared with the assessment by a dermatologist and a dermatological nurse. Standardized information was given to the patient and the form was filled in independently by the patient, the nurse and the dermatologist, during the patient’s visit to the clinic. Individual area scores were summed to a total score.

Results  The overall agreement was good, with an interclass correlation (ICC) of 0·61 between patient and dermatologist for the total score. The ICC between nurse and dermatologist was 0·78. Differences between observers were more pronounced for the more severe cases – those with higher numerical scores as assessed by the dermatologist. There was a tendency for women and for patients over the median age of 44 years to set a lower point score than the dermatologist. The concordance of observations from individual anatomical areas was higher for fingertips and nails and lower for the palm and dorsum of the hand.

Conclusions  Patients are able to report the extent of hand eczema with good accuracy. Self-assessment protocols for hand eczema may well have a place in the monitoring of hand eczema extent over time.