Molecular Classification in a Cohort of Occupational Dermatological Patients: Diagnostic Results and Course of Ability to Work and Sick Leave Over Two Years.

Hand eczema is the most common occupational skin disease (OSD), often leading to sick leave or job termination. Standard diagnostic procedures are often ambiguous. Molecular classification has been described to improve differentiation between eczema and psoriasis, which is the most common differential diagnosis. Since 2020, a cohort of 287 patients with suspected, occupational hand and/or foot dermatoses (eczema or psoriasis) has been established in Germany. The current analysis focuses on descriptive results on the days of absence from work, occupational retention and legal recognition of OSD after 24 months. A total of 38.9% of the patients did not receive a distinct clinical diagnosis, while molecular diagnostics provided results in 93.1% of these cases. Sick leave days significantly decreased over 2 years (p<0.005) from a mean of 28.7 to 8.2 days. Legal recognition of OSD tripled from 10.1% to 30.2%. Job terminations due to skin diseases reached 27.1%, primarily from job changes or unemployment. Molecular diagnostics enhance diagnostic precision and may support improved prevention and disease management, reducing sick leave. The findings underscore the individual severity and social impact of skin diseases like eczema and psoriasis in high-risk employments.