Hand and Upper Extremity Function in Workers With Hand Dermatitis

Abstract

Traditional methods of assessing impairment associated with skin conditions focus on clinical severity, medication usage, activities of daily living, and quality of life. Assessment of function and ability to work may provide important additional information when determining readiness to work. The objective was to gain an understanding of the functional impairment of the hand and upper extremity associated with hand dermatitis and the impact of hand dermatitis on quality of life, work instability, and productivity. Sixty-two patients with suspected contact dermatitis of the hands participated in physical and functional assessments of the upper extremity and patient-reported questionnaires including Dermatology Life Quality Index, Short Form 36 Health Survey, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Work Instability Scale, and Work Limitations Questionnaire. Numbness and finger joint restrictions were moderate to severe in 29% and 30% of the workers, respectively. Positive Tinel and/or Phalen signs occurred in 25%. Forty-eight percent reported moderate-to-high work instability, and 31% reported a greater than 10% decrease in work productivity. Thirty-five percent missed work in the past year, 19% were doing a different job, and 9% were not working. Patients with hand dermatitis demonstrate significant functional compromise of the hand and a decrease in ability to work.