Novel treatment of chronic severe hand dermatitis with bexarotene gel

Abstract

Bexarotene gel appears to be safe, tolerated by most patients, with useful therapeutic activity in chronic severe hand dermatitis.

Oral Alitretinoin (9-cis-Retinoic Acid) Therapy for Chronic Hand Dermatitis in Patients Refractory to Standard Therapy

“…7,19 A hypothesis of retinoid X receptor-mediated activity is supported by the activity of bexarotene, a retinoid X receptor agonist, applied topically as a 1% gel twice daily or 3 times daily in patients with severe CHaD. 20 However, at present, the therapeutic effect of alitretinoin cannot be explicitly linked to a particular pattern of receptor binding and consequent biological effects. 7 The encouraging results of this trial support further clinical studies of alitretinoin in the treatment of patients with CHaD.…”

Hand Dermatitis: A Review of Clinical Features, Prevention and Treatment

“…A study concluded that topical bexarotene had potential use in severe chronic hand dermatitits. A high rate of treatment-related irritation was reported (29 %) [77]. Oral acitretin led to 50 % average improvement in the clinical score in patients with tylotic eczema for 4 weeks, with no additional improvement with longer treatment.…”

A Novel Case of Recalcitrant Juvenile Pityriasis Rubra Pilaris with Response to Bexarotene

“…Pertinent to hyperproliferative cutaneous conditions, bexarotene has antikeratinizing activity as a topical agent and has been shown to cause thinning of the stratum corneum in the rhino mouse model [8]. It has also been hypothesized that bexarotene decreases inflammation through interaction with PPARs, which may reduce inflammatory cytokine expression [8,9]. Bexarotene can also inhibit T-cell accumulation in CTCL [8].…”

“…These receptors homodimerize and bind DNA to affect the function of genes downstream of retinoid acid response elements (RAREs) [7]. Additionally, RXRs have the unique capacity to heterodimerize with other classes of nuclear receptors, including RARs, vitamin D receptor (VDR), thyroid receptor (TR), and peroxisome proliferation activating receptors (PPARs) [8,9]. Therefore, retinoids that bind RXRs, also known as "rexinoids," can affect a variety of cellular pathways.…”