433 Outcome measures demographics and characteristics in predicting hand eczema severity in atopic dermatitis patients

Hand eczema (HE) although is a simple umbrella term used in diagnosis, is a heterogeneous disease entity with multifactorial causative factors including irritant and allergic contact dermatitis (ICD and ACD, respectively) and atopic dermatitis (AD). An underlying defect in the skin barrier dysfunction driving AD is also a substantial explanation for not only encouragement of percutaneous penetration of allergens and irritants but also activation of local immune system seen in HE. This might also explain why ACD is often preceded by ICD. Atopic dermatitis is an established risk factor for HE with a strongly increased prevalence of two to fourfold including positive associations between AD and occupational HE. Hand eczema has a wide clinical spectrum; patients with hand eczema and AD have different clinical and epidemiological characteristics compared with hand eczema patients in general population. Identifying clinical cues, performing appropriate patch tests and determining presence of atopy is critical for assessing the severity and burden of HE, thus heavily influencing management paths and occupational choices. This study aims to explore objective (physician assessed) and subjective (patient assessed) outcome measures, demographic determinants and clinical findings in predicting the severity of hand eczema in patients with a definite diagnosis of atopic dermatitis. Database was created from patient filled questionnaires and analysed using SAS 2023 software. Objective physician assessments EASI, BSA, IGA, SCORAD and subjective patient assessments O_SCORAD and PtGA, demographic determinants including age at presentation and onset, race, gender, insurance types and clinical features were explored in predicting the severity of HE. A total of 1170 patients with were examined. Severity in IGA had clear association with severity on HE with stronger predictability in Moderate and Severe IGA (P < 0.0001 with 95% CI). Amongst patients with clear to almost clear IGA (score = 0), (98.3%) of patients with did not have HE, (0.9%) had mild HE, (0.4%) had moderate HE and (0.4%) had severe HE. Amongst the patients with a mild IGA score of 1, 95% did not have HE, 3.3% had mild HE, 1.1% had moderate HE and 0.4% had severe HE. Amongst the patients with a moderate IGA score of 2, 88.1% did not have HE, 8.8% had mild HE, 2.8% had moderate HE and 0.4% had severe HE. Amongst the patients with a severe IGA score of 3, 69.2% did not have HE, 16.7% had mild HE, 12.6% had moderate