Establishment of a cohort for long-term observation of occupational dermatological patients for whom the so-called "Molecular Classifier" for differentiating between atopic eczema and psoriasis was performed

Status:

completed

Aims:

The aim is to examine whether the use of molecular diagnostics (in the form of a skin biopsy) can support the challenging differentiation between eczema and psoriasis on the hands. The aim is to clarify whether a diagnosis made in this way reduces the number of days missed due to illness, makes it possible to continue working in the long term, reduces the individual burden of illness and improves health-related quality of life.

Activities/Methods:

A cohort of 287 subjects with suspected occupational dermatosis of the hands was established. Participants were recruited from dermatology clinics and practices throughout Germany. A biopsy was taken from the affected skin areas and analyzed using molecular diagnostics. Subsequently, the participants were followed up over a period of 3 years using standardized survey instruments.

Results:

• 95% of clinically unclear diagnoses could be classified using molecular diagnostics.
• Patients with a precise diagnosis received more effective, targeted therapies. The proportion of cortisone preparations used fell by around 30 percentage points after 1 year. At the same time, the use of systemic therapies increased.
• The course of the disease was statistically significantly milder after 3 years. After 1 year, 25% of the participants had no or only mild skin disease. After 3 years, 40% of the participants had no or only mild skin disease.
• There was a statistically significant reduction in days of incapacity to work, and long periods of illness in particular were reduced. At inclusion, there was a median of 1 day of absence from work in the previous 12 months, with a wide range of 0-350 days. After 1 year, the number of sick days was reduced statistically significantly (p<.0005) to a median of 0 days. Only 3.8% of participants reported more than 100 days of sick leave. After 3 years, 9.8% of participants reported periods of sick leave of between 42 and 84 days.
• Fewer patients gave up their job due to the skin disease than in the control group. In this study, 13% reported giving up their job after 1 year. This proportion fell by one percentage point to 12% after 3 years. In the control group, an increase from 11% (1 year) to 18% (3 years) was observed.
• The general dermatological quality of life improved significantly.

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