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Ultravioletttherapie des chronischen Handekzems

Ultraviolet therapy in patients with chronic hand eczema

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Zusammenfassung

Die Therapie des Handekzems wird von der Gabe topischer Glukokortikosteroide dominiert. Beim Versagen einer topischen Therapie ist die UV-Therapie als Mono- oder Kombinationstherapie die beste Second-line-Option. Mit guter Effektivität und relativ geringen Nebenwirkungen lassen sich UV-B- und PUVA-Therapien durchführen. Aufgrund des lokalisierten Charakters der Erkrankung ist eine topische PUVA-Therapie der systemischen PUVA-Therapie vorzuziehen. Unter den topischen Verfahren ist die Creme-PUVA-Therapie mit hoher Effektivität einfach und sicher durchzuführen. Jüngste klinische Untersuchungen zeigen die hohe therapeutische Effektivität eines neuen Retinoids, des Alitretinoins, einer 9-cis-Retinsäure. Allerdings kommt es auch bei dieser Therapie nicht zu einer kompletten Abheilung bei allen Patienten. Unter dem Primat einer multimodalen Therapie sollte die UV-Therapie bei nicht ausreichendem Ansprechen der oralen Retinoide als Kombinationstherapie eingesetzt werden.

Abstract

Treatment of hand eczema is dominated by the administration of topical glucocorticosteriods. If topical treatment fails, the best second-line option is ultraviolet (UV) therapy alone or as combination therapy. UVB and PUVA (psoralen plus UVA) therapy is effective and has relatively few side effects. Due to the localized nature of the disease, topical PUVA therapy is preferable to systemic PUVA treatment. Among the topical methods, cream PUVA therapy is simple, safe and highly effective. Recent clinical studies have demonstrated the therapeutic efficacy of a new retinoid called alitretinoin, a 9-cis-retinoic acid. However, even this form of treatment does not lead to a complete cure in all patients. Under the primacy of multimodal treatment, UV therapy should be administered as combination therapy if oral retinoids are not sufficiently effective.

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  1. Hautklinik, Klinikum Lippe-Lemgo, Rintelner Straße 85, 32657, Lemgo, Deutschland

    H. Stege

  2. Hautklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

    H. Stege

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Stege, H. Ultravioletttherapie des chronischen Handekzems. Hautarzt 59, 696–702 (2008). https://doi.org/10.1007/s00105-008-1558-3

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