Skip to main content

Systemic Treatment of Hand Eczema: Retinoids

  • Chapter
  • First Online:
Textbook of Hand Eczema
  • 1239 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 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.

    PubMed  Google Scholar 

  2. Agner T, Held E. Skin protection programmes. Contact Dermatitis. 2002;47:253–6.

    Article  PubMed  Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  CAS  PubMed  Google Scholar 

  6. Veien NK, Menne T. Treatment of hand eczema. Skin Ther Lett. 2003;8(5):4–7.

    CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  CAS  PubMed  Google Scholar 

  9. Bollag W, Ott F. Successful treatment of chronic hand eczema with oral 9-cis-retinoic acid. Dermatology. 1999;199(4):308–12.

    Article  CAS  PubMed  Google Scholar 

  10. 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.

    Article  CAS  PubMed  Google Scholar 

  11. 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.

    Article  CAS  PubMed  Google Scholar 

  12. 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.

    Article  CAS  PubMed  Google Scholar 

  13. 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.

    Article  CAS  PubMed  Google Scholar 

  14. 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.

    Article  CAS  PubMed  Google Scholar 

  15. 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.

    Article  CAS  PubMed  Google Scholar 

  16. 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.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tove Agner M.D., M.Sc. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints 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)

Publish with us

Policies and ethics