Novel treatment of chronic severe hand dermatitis with bexarotene gel.
BACKGROUND
Hand dermatitis is an eczematous inflammation of the hands that is related to occupation or to routine activities. It often becomes chronic, and in some patients may become severe and disabling. Topical corticosteroids are effective treatment, particularly for milder forms, but they often lose effectiveness with time and can produce skin atrophy.


OBJECTIVE
To evaluate bexarotene gel topical therapy for safety, tolerability and efficacy in patients with chronic hand dermatitis.


METHODS
A phase I-II open-label randomized clinical study of bexarotene gel, alone and in combination with a low- and a mid-potency steroid, was conducted in 55 patients with chronic severe hand dermatitis at two academic clinics.


RESULTS
Patients using bexarotene gel monotherapy reached a 79% response rate for > or = 50% clinical improvement and a 39% response rate for > or = 90% clearance of hands. Adverse events possibly related to treatment in all patients were stinging or burning (15%), flare of dermatitis (16%) and irritation (29%). Thirteen patients (24%) withdrew early, including two for related adverse events and five for inadequate response.


CONCLUSIONS
Bexarotene gel appears to be safe, tolerated by most patients, with useful therapeutic activity in chronic severe hand dermatitis.
Hanifin
J M
JM
Department of Dermatology, Oregon Health Sciences University, Portland, OR 97201, USA.
Stevens
V
V
Sheth
P
P
Breneman
D
D
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D016588:Anticarcinogenic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000077610:Bexarotene; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004485:Eczema / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005782:Gels; D006225:Hand / Q000473:pathology; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013764:Tetrahydronaphthalenes / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D016588:Anticarcinogenic Agents; D003879:Dermatologic Agents; D005782:Gels; D013764:Tetrahydronaphthalenes; D000077610:Bexarotene