Abstract
Systemic treatment of hand eczema is typically considered after a full diagnostic workup has been completed and first- and second-line therapy have failed. The patient should be thoroughly informed about expectations, duration of therapy, and possible side effects. The systemic therapy chosen depends on the patient’s lifestyle and the subclass of the eczema. Retinoids are generally effective, particularly for patients with hyperkeratotic eczema, and are usually well tolerated. Advantages and disadvantages for treatment with acitretin and alitretinoin will be discussed in this chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Lynde C, Guenther L, Diepgen TL, Sasseville D, Poulin Y, Gulliver W, et al. Canadian hand dermatitis management guidelines. J Cutan Med Surg. 2010;14:267–84.
Agner T, Held E. Skin protection programmes. Contact Dermatitis. 2002;47:253–6.
Agner T, Andersen KE, Brandao FM, Bruze M, Bruynzeel DP, Frosch P, EECDRG, et al. Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients. Contact Dermatitis. 2008;59(1):43–7.
Diepgen T, Agner T, Aberer W, Berth-Jones J, Cambazard F, Elsner P, et al. Management of chronic hand eczema. Contact Dermatitis. 2007;57(4):203–10.
Diepgen TL, Andersen KE, Brandao FM, Bruze M, Bruynzeel DP, Frosch P, et al. Hand eczema classification: a cross-sectional, multicentre study of the aetiology and morphology of hand eczema. Br J Dermatol. 2009;160(2):353–8.
Veien NK, Menne T. Treatment of hand eczema. Skin Ther Lett. 2003;8(5):4–7.
Schmitt-Hoffmann AH, Roos B, Sauer J, Schleimer M, Kovācs P, Stoeckel K, et al. Influence of food on the pharmacokinetics of oral alitretinoin (9-cis retinoic acid). Clin Exp Dermatol. 2011;36 Suppl 2:18–23.
Thestrup-Pedersen K, Andersen KE, Menne T, Veien N. Treatment of hyperkeratotic dermatitis of the palms (eczema keratoticum) with oral acitretin. A single-blind placebo controlled study. Acta Derm Venereol. 2001;81:353–5.
Bollag W, Ott F. Successful treatment of chronic hand eczema with oral 9-cis-retinoic acid. Dermatology. 1999;199(4):308–12.
Ruzicka T, Larsen FG, Galewicz D, Horváth A, Coenraads PJ, Thestrup-Pedersen K, et al. Oral alitretinoin (9-cis-retinoic acid) therapy for chronic hand dermatitis in patients refractory to standard therapy: results of a randomized, double-blind, placebo-controlled, multicenter trial. Arch Dermatol. 2004;140(12):1453–9.
Ruzicka T, Lynde CW, Jemec GB, Diepgen T, Berth-Jones J, Coenraads PJ, et al. Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial. Br J Dermatol. 2008;158(4):808–17.
Bissonnette R, Worm M, Gerlach B, Guenther L, Cambazard F, Ruzicka T, et al. Successful retreatment with alitretinoin in patients with relapsed chronic hand eczema. Br J Dermatol. 2010;162(2):420–6.
Aguayo-Leiva IR, Urrutia S, Jaén-Olasolo P. Response to treatment with oral alitretinoin in patients with chronic hand eczema that is refractory to treatment with potent topical corticosteroids: experience in 15 patients. Actas Dermosifiliogr. 2011;102(8):616–22.
Dirschka T, Reich K, Bissonnette R, Maares J, Brown T, Diepgen TL. An open-label study assessing the safety and efficacy of alitretinoin in patients with severe chronic hand eczema unresponsive to topical corticosteroids. Clin Exp Dermatol. 2011;36(2):149–54.
Diepgen TL, Pfarr E, Zimmermann T. Efficacy and tolerability of alitretinoin for chronic hand eczema under daily practice conditions: results of the TOCCATA open study comprising 680 patients. Acta Derm Venereol. 2012;92:251–5.
Lynde C, Cambazard F, Ruzicka T, Sebastian M, Brown TC, Maares J. Extended treatment with oral alitretinoin for patients with chronic hand eczema not fully responding to initial treatment. Clin Exp Dermatol. 2012;37(7):712–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Agner, T. (2014). Systemic Treatment of Hand Eczema: Retinoids. In: Alikhan, A., Lachapelle, JM., Maibach, H. (eds) Textbook of Hand Eczema. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39546-8_35
Download citation
DOI: https://doi.org/10.1007/978-3-642-39546-8_35
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-39545-1
Online ISBN: 978-3-642-39546-8
eBook Packages: MedicineMedicine (R0)