Testing the Hand Eczema Severity Index

Summary Hand eczema is an inflammation of the skin of the hands, which can cause the skin to itch or develop painful cracks. It is a common skin disease that affects about one in every ten people. The Hand Eczema Severity Index (HECSI) is a much used scoring system to measure how severe a person's hand eczema is. It gives a score from 0‐360, but it is not yet known what these scores exactly mean, or if the instrument can pick up changes when the severity of the hand eczema changes. Researchers from The Netherlands have studied this. They scored the hands of 294 patients with hand eczema with the HECSI and also compared the hands with photographs showing various stages of hand eczema severity. After 4‐12 weeks they did this again. The researchers found that the HECSI score improved and worsened when, according to the photographs, the hand eczema did. This means that the HECSI is able to pick up changes in hand eczema severity. They also found that the following HECSI scores were comparable to the photographic stages of severity: clear, 0; almost clear, 1‐16; moderate, 17‐37; severe, 38‐116; very severe, ≥117. Finally, the researchers found that an improvement of 41 points on the HECSI was the minimal improvement a patient had to make to be an important, true improvement. With these scores, doctors and researchers can more easily use the HECSI in daily practice and in studies on hand eczema patients. This is a summary of the study: Responsiveness and interpretability of the Hand Eczema Severity Index