The Hand Eczema Trial (HET): design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema

We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index); self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life.The trial is registered in ClinicalTrials.Gov, NCT01012453.Hand eczema (HE) is a long-lasting disease with a point prevalence of 9.7% in the background population [1] and an incidence reported to be 5.5 to 8.8 per 1000 person-years [2,3]. Occupational hand eczema (OHE) is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years [4]. Other studies have revealed that the annual incidence of new reports of occupational skin diseases is 0.7 to 0.8 per 1,000 employees [5,3] and the number of unreported occupational skin conditions are many times greate