Hand eczema: treatment

Abstract

Hand eczema is a highly prevalent, multietiological disease with a wide spectrum of severity and chronicity. The treatment of hand eczema, especially in severe and chronic cases, is a challenge to the dermatologist requiring not only diagnostic and therapeutic, but also excellent patient communication skills. This review discusses the spectrum of therapeutic options for hand eczema, the evidence for their efficacy and safety, and proposes a stepwise approach of intensity of treatment depending on disease severity and chronicity. In the near future, hand eczema patients may benefit from new therapeutic principles such as biologics for the treatment of atopic eczema and topical Janus Kinase inhibitors.

Hand eczema—A growing dermatological concern during the COVID ‐19 pandemic and possible treatments

“…4 In case of active HE, a detailed history must always be taken, and additional examination such as patch skin testing or atopy score should be considered to identify underlying contact allergy or atopic dermatitis. 6 The treatment of HE varies based on the severity of symptoms and disease phase (acute, chronic), with emollients and moisturizers being the baseline. Topical steroids such as clobetasol propionate and mometasone furoate are usually the first-choice anti-inflammatory agents, though they may interfere with the skin barrier regeneration and thus their long-term This article is protected by copyright.…”

“…In the case of HE refractory to topical corticosteroids, PUVA-therapy may be introduced. 6 Lastly, systemic agents should be considered in severe cases refractory to topical treatment.…”

“…alitretinoin, acitretin, and immunosuppressants such as methotrexate, azathioprine, and cyclosporine A. 6 Despite the lack of evidence on the increased risk of severe COVID-19 in immunocompromised patients, 7,8 we believe that the first-line systemic treatment should involve oral retinoids followed by immunosuppressants in recalcitrant cases.…”

Systemic therapy and the use of complementary and alternative medicine in patients with recognized occupational hand eczema in Denmark: A cross‐sectional questionnaire‐based study

“…While some patients with HE can be successfully treated by topical treatment or UV therapy, others are recalcitrant to these treatments and systemic therapy may then be needed to obtain disease control. 9,10 To better elucidate whether a lack of efficient treatment may promote chronicity and possibly encourage use of CAM, more data on treatment of patients with HE are needed. The primary aim of this study was to investigate which treatments are being offered to patients with chronic OHE in Denmark, with a focus on systemic therapy, and relate this to demographic data as well as disease-related variables.…”

“…While some patients with HE can be successfully treated by topical treatment or UV therapy, others are recalcitrant to these treatments and systemic therapy may then be needed to obtain disease control . To better elucidate whether a lack of efficient treatment may promote chronicity and possibly encourage use of CAM, more data on treatment of patients with HE are needed.…”