Self-Reported Disease Severity and Treatment Experience among Individuals Reporting Healthcare Professional-Diagnosed Chronic Hand Eczema: Findings from the Cross-Sectional CHECK-US Study

INTRODUCTION: Chronic hand eczema (CHE) is a chronic inflammatory skin disease with persistent symptoms that exert substantial clinical burden on patients. Real‑world data on CHE patient experience remain limited in the USA. This study aimed to assess symptoms across different severity and treatment groups and describe treatments, signs, and symptoms in participants with self‑reported CHE in the USA. METHODS: This online cross-sectional survey included adults (aged 18-69 years) with self-reported CHE, recruited through general population panels. Subgroups were based on (1) participants' worst self-evaluated CHE severity in the past 12 months using a photographic guide as mild, moderate, and severe, and within those with moderate to severe CHE, as a subset with suboptimal response to topical corticosteroids (TCS); and (2) current treatments (systemics/phototherapy, TCS, topicals, no treatment, and never treated). Participants reported TCS use/experience and flare experience. Symptom severity (itch, pain, sleep disturbance) over past 24 h was assessed using visual analog scales (VAS). RESULTS: Among 982 participants with healthcare-professional (HCP)-diagnosed CHE, 87.8% reported their CHE as moderate to severe in the past 12 months. Most participants (79.7%) reported being treated currently for CHE, with 31.8% on TCS. At the time of survey, 62.9% reported a flare, with increased itch being the most common symptom. Participants with moderate to severe (versus mild) signs experienced increased itch, redness, and appearance of new skin lesions (p < 0.05). Spreading of lesions was more common among participants with suboptimal response to TCS (p = 0.006). Overall, itch had the highest mean (SD) VAS score of 5.0 (2.8). Symptom severity was notably higher among those receiving systemic treatments/phototherapy versus TCS. CONCLUSIONS: Moderate to severe CHE was common among participants, with TCS alone (without concurrent systemic or phototherapy use) being the most frequently observed treatment option. Participants with CHE continue to experience signs/symptoms despite receiving treatment, underscoring the need for more effective treatment options. Graphical abstract available for this article.