Table 4.
Overview of HESD item understanding and relevance
| HESD item | Reported during CE | CD understanding | CD relevance | Example supportive quotes | ||
|---|---|---|---|---|---|---|
| S | P | Total | ||||
| Itch | 19/20 | 1/20 | 20/20 | 20/20 | 20/20 | “…I'm itchy all the time.” (Female aged 65 with severe atopic CHE) |
| Burning | 13/20 | – | 13/20 | 20/20 | 18/20 | “…burning means like it’s just a really hot sensation” (Male aged 57 with mild allergic CHE) |
| Pain | 12/20 | 6/20 | 18/20 | 20/20 | 18/20 | “…it’s painful…pain in there that you just can’t stand it.” (Female aged 33 with moderate atopic CHE) |
| Cracked skin | 11/20 | 8/20 | 19/20 | 20/20 | 19/20 | “…basically like splitting or separation of the skin, um, and like it’s visible or I can feel it.” (Male aged 41 with severe allergic CHE) |
| Redness | 17/20 | 3/20 | 20/20 | 20/20 | 20/20 | “…redness, how red. How, how itching, you know, changes color from your normal skin to the redness.” (Female aged 33 with moderate atopic CHE) |
| Heat | 7/20 | 5/20 | 12/20 | 19/20 | 14/18 | “…it’s mostly when you’re scratching on the hand is when it starts, you know, kind of getting warm or hot.” (Male aged 38 with moderate atopic CHE) |
| Dry skin | 17/20 | 1/20 | 18/20 | 20/20 | 20/20 | “Dryness to me is when it feels really rough and like not calloused…Like you could hear the roughness of it.” (Female aged 18 with mild atopic CHE) |
| Swelling | 8/20 | 8/20 | 16/20 | 20/20 | 14/20 | “…I get to scratching, and they swell up.” (Male aged 51 with moderate irritant CHE) |
| Blisters | 6/20 | 5/20 | 11/20 | 19/20 | 14/20 | “…when I think of blisters I think of actual puffiness…and maybe having a little liquid in it.” (Male aged 41 with severe allergic CHE) |
| Bleeding | 9/20 | 6/20 | 15/20 | 20/20 | 13/19 | “…any time my hands crack and they split then you could, you could see the bleeding.” (Female aged 53 with moderate atopic CHE) |
| Thickening | 6/20 | 11/20 | 17/20 | 19/20 | 15/20 | “Thickening, I think just like calluses and stuff, like roughness.” (Female aged 54 with mild irritant CHE) |
| Flaking | 10/20 | 4/20 | 14/20 | 20/20 | 18/20 | “…it’s just basically thin layers of your skin, dried skin coming off…It’s just little pieces of dried skin that peels off.” (Female aged 40 with severe atopic CHE) |
| Roughness | 12/20 | 5/20 | 17/20 | 20/20 | 20/20 | “It’s the, the texture of your skin. Like where if you have normal hand texture it’s smooth and soft. This is not smooth or soft.” (Female aged 40 with severe atopic CHE) |
| Hardnessa | 10/20 | 1/20 | 11/20 | 10/10 | 8/10 | “The skin… definitely gets hard. You can feel it.” (Male aged 61 with mild irritant CHE) |
| Oozing/weepinga | 5/20 | 6/20 | 11/20 | 10/10 | 6/10 | “It’s kind of the same as blisters… sometimes it comes like even when you scratch it and when you open it, like when you have a crack and then it starts maybe oozing like a little water.” (Female aged 25 with moderate allergic CHE) |
CD Cognitive Debriefing; CE Concept Elicitation; HESD Hand Eczema Symptom Diary; S concepts mentioned spontaneously; P concepts only mentioned when probed by the interviewer
aItems only debriefed in round 2 (n = 10)