Management of Chronic Hand Eczema

Actas Dermosifiliogr. 2015 Sep;106(7):533-44. doi: 10.1016/j.ad.2015.04.005. Epub 2015 May 23.
[Article in English, Spanish]

Abstract

Management of hand eczema is complex because of the broad range of different pathogeneses, courses, and prognoses. Furthermore, the efficacy of most available treatments is not well established and the more severe forms can have a major impact on the patient's quality of life. Patient education, preventive measures, and the use of emollients are the mainstays in the management of hand eczema. High-potency topical corticosteroids are the treatment of choice, with calcineurin inhibitors used for maintenance. Phototherapy or systemic treatments are indicated in patients who do not respond to topical treatments. Switching from topical treatments should not be delayed to avoid sensitizations, time off work, and a negative impact on quality of life. Alitretinoin is the only oral treatment approved for use in chronic hand eczema.

Keywords: Clinical practice guidelines as topic; Eczema; Guías de práctica clínica como asunto; Hands; Manos; Terapia; Therapy.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Alitretinoin
  • Calcineurin Inhibitors / therapeutic use
  • Chronic Disease
  • Combined Modality Therapy
  • Dermatitis, Contact / drug therapy
  • Dermatitis, Contact / prevention & control
  • Dermatitis, Contact / therapy
  • Dermatologic Agents / therapeutic use*
  • Disease Management
  • Eczema / drug therapy*
  • Eczema / prevention & control
  • Eczema / therapy
  • Emollients / therapeutic use
  • Gloves, Protective
  • Hand Dermatoses / drug therapy*
  • Hand Dermatoses / prevention & control
  • Hand Dermatoses / therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Occupational Diseases / drug therapy
  • Occupational Diseases / prevention & control
  • Occupational Diseases / therapy
  • Phototherapy
  • Practice Guidelines as Topic
  • Quality of Life
  • Tretinoin / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Calcineurin Inhibitors
  • Dermatologic Agents
  • Emollients
  • Immunosuppressive Agents
  • Alitretinoin
  • Tretinoin