title: [Management of chronic hand eczema].
abstract: The management of hand eczema, more readily called chronic hand dermatitis, is complex. This heaviness is related not only to the disease itself by its different clinical forms but also the multiplicity and diversity of etiological factors, triggering / maintaining or aggravating factors. The repeated therapeutic failures are ransom of incorrect information about the disease and its environment, a lack of clarity in the prescription and duration of treatment in general too short. The reference treatment is high potency topical steroids with or without occlusion for 4-8 weeks followed by alitretinoin 30 mg / day for at least 3-6 months with a monthly lipid and liver monitoring and mandatory monthly pregnancy test in women of childbearing. Associated measures and patient education are the cornerstones of successful treatment. Other alternative treatments such as phototherapy, methotrexate, cyclosporin, mycophenolate mofetil etc. can be considered in case of resistance or for clearing followed by topical treatments.
authors: Service de dermatologie, pôle Spécialités Médicales, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France. Electronic address: lahfa.m@chu-toulouse.fr.
authors: M
authors: M
authors: Lahfa
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000465:Algorithms; D000077556:Alitretinoin; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000627:therapeutic use; D019468:Disease Management; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D004485:Eczema / Q000188:drug therapy / Q000628:therapy*; D004643:Emollients / Q000627:therapeutic use; D005260:Female; D006229:Hand Dermatoses / Q000188:drug therapy*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D010353:Patient Education as Topic; D010789:Phototherapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011258:Pregnancy Tests; D020156:Salicylic Acid / Q000627:therapeutic use; D014212:Tretinoin / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D004643:Emollients; D006633:Histamine Antagonists; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000077556:Alitretinoin; D014212:Tretinoin; D020156:Salicylic Acid
keywords: Alitretinoine; Alitrétinoïne; Chronic hand dermatitis; Chronic hand eczema; Dermite chronique des mains; Dermocroticoides; Eczéma chronique des mains; Education; Immunosuppressants; Immunosuppresseurs; Local treatment; Management; Prise en charge; Topical corticosteroids; Traitement locaux; Éducation