Molecular diagnostics in occupational dermatology for optimized differentiation of eczema and psoriasis in the Heidelberg occupational dermatology cohort

Status:

ongoing

Aims:

Skin diseases (BK5101) are one of the most common suspected occupational diseases and affect a large number of employers' liability insurance associations and accident insurances. Hand eczema is one of the most common skin diseases, particularly in occupational dermatology. Molecular diagnostics help to optimize the often challenging differential diagnosis of eczema and psoriasis. The FB-0323 research project "Establishment of a cohort for long-term observation of occupational dermatological patients for whom the so-called "Molecular Classifier" for differentiating between atopic eczema and psoriasis was performed" to date has shown a reduction in clinically unclear cases by over 95%, thus enabling a reliable diagnosis to be made. This means that a specific therapy can be initiated at an early stage, the course of the disease can be shortened, the burden of the disease reduced and, if necessary, the standardized procedure of reporting occupational skin diseases ("Hautarztverfahren") can be shortened. In addition, periods of incapacity to work can be reduced and the health-related quality of life can be improved.

The aim of this follow-up study is to analyze the long-term development of the variables of disease progression, topical and systemic therapies used, professional activity, occupational retention and quality of life after the application of molecular diagnostics. In addition, if the dermatosis persists, the molecular classifier will be used again in the same way as the skin biopsy at the beginning of the previous study in order to investigate the change or constancy of the molecular structure and to compare it with the clinical and/or histological assessment. Samples should also be taken by means of a so-called "tape-stripping". This may be able to replace skin biopsies in the medium term and thus reduce the burden on patients.

Activities/Methods:

In the course of this multicenter cohort study, further longitudinal data will be collected from subjects of the existing cohort of occupational dermatology patients. For this purpose, all patients will receive standardized survey instruments over 3 years to collect:

1. sociodemographic data
2. persistence or healing of the skin disease
3. localization of the skin disease
4. course of the skin disease (continuous, chronic, chronic-relapsing, healed)
5. local and systemic therapies carried out
6. career retention, career termination, retirement
7. general and dermatological quality of life (EQ5D, DLQI and QOLHEQ) - pruritus severity.

For persons with persisting skin lesions, the molecular classifier should be determined again on the same body site(s). The sample will be performed by conventional skin biopsy and also by means of a tear-off test/"tape stripping".

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