Is a worker's understanding of their diagnosis an important determinant of outcome in occupational contact dermatitis?
The possible effect of an individual's knowledge of their diagnosis on their disease outcome was examined in a group of 230 workers with occupational contact dermatitis. The workers were surveyed with an interviewer-administered questionnaire for an average of 5 years following a diagnosis of occupational contact dermatitis. 48% had allergic contact dermatitis and 52% had irritant contact dermatitis. There was a poor correlation between the workers' recalled diagnosis and the actual diagnosis, but better concordance with their recollection of patch test results. Only 33% correctly identified their diagnosis. Those who could not were approximately 2 x as likely to still have active dermatitis, to have more severe dermatitis and to note that their skin problem interfered with their work and home activities. Those who had no idea of their diagnosis were 3 x as likely to have these problems. These results raise the possibility that further efforts directed at the patient's education with respect to their condition might improve the outcome of their occupational skin disease.