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Phototherapy in Hand Dermatitis

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Textbook of Hand Eczema

Abstract

Although the majority of chronic hand dermatitis can successfully be managed by dry skin care, contact avoidance, and topical steroidal or nonsteroidal therapies, phototherapy remains a useful adjunctive tool for the management of recalcitrant cases. Phototherapy, irradiation with ultraviolet light (UV), is administered via one of several modalities: UVA (400–320 nm), UVA-1 (400–340 nm), PUVA (psoralen plus UVA), UVB (320–270 nm), narrowband UVB (313–308 nm), or monochromatic excimer light (308 nm). At present, PUVA remains the most investigated type of phototherapy and the standard for comparison. UVA-1 and the various UVB therapies may offer comparable clinical improvements to PUVA therapy. A recent development is the availability of home oral PUVA and UVB therapies, which offer similar therapeutic benefits to clinically administered therapy with less disruption of the patient’s daily activities. Relapse rates are high for all phototherapy subtypes, but less frequent maintenance treatments may aid in sustaining continued clearance. Despite this high frequency of relapse, phototherapy is a useful adjunctive treatment option for recalcitrant chronic hand dermatitis.

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Notes

  1. 1.

    For the purpose of this chapter, treatment-resistant/recalcitrant, chronic hand dermatitis (CHD) is defined as an eczematous dermatitis (atopic, dyshidrotic, hyperkeratotic, nummular, allergic contact, or irritant contact dermatitis) limited to the hands and feet that has persisted for greater than 6 months without two continuous weeks of clearance despite adequate contact avoidance, dry skin care, and topical therapy (steroidal and nonsteroidal immunomodulatory agents) [3].

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Author information

Authors and Affiliations

  1. School of Medicine, University of Mississippi, 2500 N. State Street, Jackson, MS, 39216, USA

    James L. Griffith Jr. M.S.

  2. Department of Dermatology, Mayo Clinic Rochester, 200 First St SW, Rochester, MN, 55905, USA

    Mark D. P. Davis M.D. & Ali Alikhan M.D.

Authors
  1. James L. Griffith Jr. M.S.
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  2. Mark D. P. Davis M.D.
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  3. Ali Alikhan M.D.
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Correspondence to Ali Alikhan M.D. .

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Editors and Affiliations

  1. Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA

    Ali Alikhan

  2. Department of Dermatology, Catholic University of Louvain, Brussels, Belgium

    Jean-Marie Lachapelle

  3. Department of Dermatology, University of California, San Francisco, California, USA

    Howard I. Maibach

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Griffith, J.L., Davis, M.D.P., Alikhan, A. (2014). Phototherapy in Hand Dermatitis. 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_32

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  • DOI: https://doi.org/10.1007/978-3-642-39546-8_32

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