COMPARISON OF THE INFLUENCE OF CYCLOSPORINE AND TOPICAL BETAMETHASONE-17,21-DIPROPIONATE TREATMENT ON QUALITY-OF-LIFE IN CHRONIC HAND ECZEMA

In a randomized, controlled parallel group study we have shown that cy closporine at 3 mg/kg/day is as effective as topical betamethasone-17, 21-dipropionate in the treatment of chronic hand eczema, In this study we compared the influence of these therapies on the quality of life, Forty-one patients were treated with either treatment for 6 weeks, aft er which patients with failure were switched to the other treatment fo r another 6 weeks, Quality of life was assessed with the Eczema Disabi lity Index (EDI) at baseline and at the end of both treatment periods, The total EDI score decreased significantly and to the same degree in both groups, i.e. from the mean value of 30.5 to 20.9 in the cyclospo rine group and from 27.2 to 18.9 in the betamethasone-17,21-dipropiona te group. Irrespective of the dimension of the EDI (daily activity, sc hool/work, personal relationship, leisure, treatment), the difference between the treatment groups at the end of the first treatment period was not significant. In the second part of the study a slight further decrease in total score was observed, but without any difference betwe en the groups, There was a significant correlation between changes in the total EDI score and changes in all the clinical assessments, i.e. disease activity, extent of the disease, itch, sleep disturbances and use of emollients, Though the significant correlation between the tota l EDI and clinical assessments makes quality of life assessments in ha nd eczema questionable, the missing correlation between some clinical assessments and dimensions of the EDI suggests that EDI views aspects of the disease not covered by clinical measures.