See if you Qualify

Pre-Screening Questions

Please do not provide any information about anyone but yourself.

1. How did you hear about us?

Please enter your zip/postal code, so we can look up where you may have heard about this study in your area:
 
2. What is your date of birth?
Month Day Year
3. What is your gender?

4. Do you currently have areas of your skin that look similar to the images below?

”Eczema” ”Eczema” ”Eczema”


5. Using your handprint (from the base of the hand to the fingertips) as a measuring tool like a ruler, in combining all areas of your body, how many handprints of eczema do you currently have? Please provide your best estimate.



6. Have you ever used topical (applied to the skin) treatments for your eczema? Some examples include:
  • Topical Corticosteroids such as: betamethasone (Celestone Soluspan, Sernivo, Diprolene AF), clobetasol (Clobex), fluocinonide (Vanos Cream®, Halog Ointment, Lidex-E Cream), hydrocortisone (Cortizone-10, Cortaid)
  • Topical Calcineurin inhibitors such as: pimecrolimus (Elidel), tacrolimus (Prograf, Protopic, Astagraf XL)
  • Topical Antibiotics such as: bacitracin, erythromycin
  • Topical Non-Steroids such as: Eucrisa (crisaborole), Atopiclair, or Eletone
  • Coal Tar Preparations
Please read through all answer options.


7. Have you made lifestyle changes such as avoiding irritants and using emollients to help treat your eczema?  

8. Have you used phototherapy, or tanning booths/beds/lamps in the past for any reason?

9. Have you used any cell-depleting agents, such as rituximab in the past?


10. Have you used any biologic medication in the past? Some examples include: HUMIRA ® (adalimumab), Stelara ® ustekinumab, and Cosentyx ® secukinumab, and Dupixent ® (dupilumab).