Social Determinants of Health Shape the Course of Chronic Hand Eczema

Sociodemographic factors and comorbidities may influence the course and severity of chronic hand eczema (CHE), according to findings from the CHECK study of U.S.-based adults with CHE presented during a poster session at the 2025 Fall Clinical Dermatology Conference in Las Vegas. Understanding individual variations can guide treatment and prevention strategies and may ultimately minimize gaps in care for people with CHE. 

CHE is an inflammatory disease of the hands and wrists that lasts 3 months or longer each year or recurs at least two times within a year. CHE is persistent and often debilitating, and may present with a combination of symptoms, including inflammation, scaling, fissures, itching, and pain. Research has shown that the impact of CHE transcends physical health, as many patients experience a high psychosocial burden related to this disease. 

Data from studies conducted in Canada, the United Kingdom, and multiple European countries suggested that sociodemographic factors, including age, sex, race, and employment status, may influence the severity of CHE, and may contribute to disparities in care and treatment outcomes.  

CHECK-US was an online survey conducted among 10,636 adult participants representative of the general population in the United States, recruited via online panels between March and May 2025. Nearly 1,000 participants who reported a physician diagnosis of CHE and completed the full questionnaire were included in the final analysis. Most participants were employed (76.4%) and lived in urban areas (86.6%). Almost 60% reported having a light skin tone, according to the Monk Skin Tone Scale, while 30% reported a medium skin tone, and approximately 10% of the cohort reported a dark skin tone. While the most frequently self-identified subtype of CHE was atopic hand dermatitis, almost half (46.5%) of the participants reported multiple CHE subtypes, with varying levels of severity in the past 7 days. Nearly two-thirds of participants (65.1%) noted that they had moderate-to-severe CHE in the past week.

The researchers also collected information about comorbidities and found that more than one quarter of the respondents lived with psychological or emotional disorders, reflecting the significant impact of CHE on patients’ mental health. 

The results showed that moderate-to-severe CHE was more frequent among younger adults (individuals aged 18-39 years) than among their older counterparts and that male patients were affected in higher proportions than women. Participants identifying as black or African American and those reporting multiple races had the highest proportions of moderate-to-severe disease. Moreover, individuals with light skin experienced moderate to severe symptoms in lower proportions (60.3%) compared with those with medium skin tones (69.8%) and those with dark skin tones (78.6%). While previous research has suggested that black and other non-white individuals with CHE may be experiencing higher disease severity and a greater impact on quality of life (Chai ESX et al. J Clin Med 2023 Mar 14;12:2232), information about racial disparities in the diagnosis and treatment of CHE remains limited. 

The authors noted that a deeper understanding of these potential disparities in disease characteristics and severity represents a critical step toward the improved management of CHE, and may serve to inform public health strategies.