European Journal of Dermatology

, Volume 25, Issue 2, pp 145–155 | Cite as

Valid screening questions useful to diagnose hand and forearm eczema are available in the Spanish language, a new tool for global research

  • Anna Martí-Margarit
  • Josep M. Manresa
  • Mike Herdman
  • Ramon Pujol
  • Consol Serra
  • Mary-Ann Flyvholm
  • Ana M. Giménez-Arnau
Clinical Report


Hand eczema is an impacting cutaneous disease. Globally valid tools that help to diagnose hand and forearm eczema are required.


To validate the questions to detect hand and/or forearm eczema included in the “Nordic Occupational Skin Questionnaire” (NOSQ-2002) in the Spanish language.

Materials and methods

Aprospective pilot studywas conducted with 80 employees of a cleaning company and a retrospective one involving 2,546 individuals. The responses were analysed for sensitivity, specificity and positive and negative predictive values. The final diagnosis according to the patients’ hospital records, the specialty care records and the physical examination was taken as gold standard. The Dermatology Life Quality Index (DLQI) was also evaluated.


Sensitivity and specificity, in a worst case scenario (WC) combining both questions, were 96.5% and 66.7%, respectively, and in a per protocol (PP) analysis, were 96.5% and 75.2%.


The questions validated detected eczema effectively, making this tool suitable for use e.g. in multicentre epidemiological studies or clinical trials.

Key words

eczema dermatitis forearms hands occupation occupational validation wrist 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Svensson Å, Lindberg M, Meding B, Sundberg K, Stenberg B. Selfreported hand eczema: symptom-based reports do not increase the validity of diagnosis. Br J Dermatol 2002; 147: 281–4.PubMedCrossRefGoogle Scholar
  2. 2.
    Moberg C, Alderling M, Meding B. Hand eczema and quality of life. Br J Dermatol 2009; 161: 397–403.PubMedCrossRefGoogle Scholar
  3. 3.
    Thyssen JP, Johansen JD, Linneberg A, Menné T. The epidemiology of hand eczema in the general population prevalence and main findings. Contact Dermatitis 2010; 62: 75–87.PubMedCrossRefGoogle Scholar
  4. 4.
    Cvetkovski RS, Zachariae R, Jensen H, Olsen J, Johansen JD, Agner T. Prognosis of Occupational Hand Eczema. Arch Dermatol 2006; 142: 305–11.PubMedCrossRefGoogle Scholar
  5. 5.
    Diepgen TL, Agner T, Aberer W, et al. Management of chronic hand eczema. Contact Dermatitis 2007; 57: 203–10.PubMedCrossRefGoogle Scholar
  6. 6.
    Vermeulen R, Kromhout H, Bruynzeel DP, de Boer EM, Brunekreef B. Dermal exposure, handwashing, and hand dermatitis in the rubber manufacturing industry. Epidemiology 2001; 12: 350–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Vermeulen R, Kromhout H, Bruynzeel DP, de Boer EM. Ascertainment of hand dermatitis using a symptom-based questionnaire; applicability in an industrial population. Contact Dermatitis 2000; 42: 202–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Smit HA, Burdorf A, Coenraads PJ. Prevalence of hand dermatitis in different occupations. Int J of Epidemiology 1993; 22: 288–93.CrossRefGoogle Scholar
  9. 9.
    Carstensen O, Rasmussen K, Ponten A, Gruvberger B, Isaksson M, Bruze A. The validity of a questionnaire-based epidemiological study of occupational dermatosis. Contact Dermatitis 2006; 55: 295–300.PubMedCrossRefGoogle Scholar
  10. 10.
    Susitaival P, Flyvholm M-A, Meding B, et al. Nordic occupational skin questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Dermatitis 2003; 49: 70–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Sala-Sastre N, Herdman M, Navarro L, et al. Principles and methodology for translation and cross-cultural adaptation of the Nordic Occupational Skin Questionnaire (NOSQ-2002) to Spanish and Catalan. Contact Dermatitis 2009; 61: 109–16.PubMedCrossRefGoogle Scholar
  12. 12.
    Bregnhoj A, Sosted H, Menné T, Johansen JD. Validation of selfreporting of hand eczema among Danish hairdressing apprentices. Contact Dermatitis 2011; 65: 146–50.PubMedCrossRefGoogle Scholar
  13. 13.
    Sackett DL, Straus ShE, Richardson WS, Rosenberg W, Haynes RB. Medicina basada en la evidencia. Cómo practicar y enseñar la MBE. 2a ed. Ed. Harcourt 2001; 91–134.Google Scholar
  14. 14.
    Lewis VL, Finlay AY. Ten years experience of the Dermatology Life Quality Index (DLQI). J Investig Dermatol Symp Proc 2004; 9: 169–80.PubMedCrossRefGoogle Scholar
  15. 15.
    Hongbo Y, Thomas CL, Harrison MA, Salek MS, Finlay AY. Translating the Science of Quality of Life into Practice: What Do Dermatology Life Quality Index Scores Mean? J Invest Dermatol 2005; 125: 659–64.PubMedCrossRefGoogle Scholar
  16. 16.
    Basra MKA, Fenech R, Gatt RM, Salek MS, Finlay AY. The Dermatology Life Quality Index 1994–2007: a comprehensive review of validation data and clinical results. Br J Dermatol 2008; 159: 997–1035.PubMedGoogle Scholar
  17. 17.
    Mirabelli M, Vizcaya D, Martí Margarit A, et al. Occupational risk factors for hand dermatitis in a population of professional cleaning workers in Spain. Draft for Contact Dermatitis 2012; 66:188–96.CrossRefGoogle Scholar
  18. 18.
    de Joode BW, Vermeulen R, Heederik D, Van Ginkel K, Kromhout H. Evaluation of 2 self-administered questionnaires to ascertain dermatitis among metal workers and its relation with exposure to metalworking fluids. Contact Dermatitis 2007; 56: 311–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Altman DG, Bland JM. Diagnosis tests 2: predictive values. BMJ 1994; 309: 102.PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Doust J. Diagnosis in general practice. Using probabilistic reasoning. BMJ 2009; 339: b3823.CrossRefGoogle Scholar
  21. 21.
    Potter J, Odutola J, Gonzales CA, Ward MM. Validation of English and Spanish-language versions of a screening questionnaire for rheumatoid arthritis in an underserved community. J Rheumatol 2008; 35: 1545–9.PubMedCentralPubMedGoogle Scholar
  22. 22.
    Yost KJ, Cheville AL, Weaver AL, Al Hilli M, Dowdy SC. Development and Validation of a Self-Report Lower-Extremity Lymphedema Screening Questionnaire in Women. Phys Ther 2013; 93: 694–703.PubMedCrossRefGoogle Scholar
  23. 23.
    Hamilton L, Macgregor A, Newman D, Belkhiri A, Toms A, Gaffney K. Validation of a Patient Self-Reported Screening Questionnaire for Axial Spondyloarthropathy in a UK Population. Spine (Phila Pa 1976). 2012; 38: 502–6.CrossRefGoogle Scholar

Copyright information

© John Libbey Eurotext 2015

Authors and Affiliations

  • Anna Martí-Margarit
    • 1
    • 2
  • Josep M. Manresa
    • 3
  • Mike Herdman
    • 4
  • Ramon Pujol
    • 1
  • Consol Serra
    • 5
    • 7
  • Mary-Ann Flyvholm
    • 6
  • Ana M. Giménez-Arnau
    • 1
  1. 1.Dermatology Unit, Hospital del MarUniversitat AutònomaBarcelonaSpain
  2. 2.Mateu Orfila Occupational Health Dermatology UnitUniversitat Pompeu FabraBarcelonaSpain
  3. 3.North Metropolitan Research Support UnitICS-IDIAP Jordi GolSabadellSpain
  4. 4.Insight Consulting & ResearchBarcelonaSpain
  5. 5.CiSAL, Centre for Research in Occupational HealthUniversity Pompeu FabraBarcelonaSpain
  6. 6.National Research Centre for the Working EnvironmentCopenhagenDenmark
  7. 7.Institut Hospital del Mar d’Investigacions MèdiquesBarcelonaSpain

Personalised recommendations