title: Clinical evaluation and assessment of the therapeutic efficacy of alitretinoin in a group of patients with chronic hand eczema refractory to topical steroid therapy.
abstract: OBJECTIVE
  We examined and evaluated the clinical characteristics of patients who had come to the Allergological and Occupational Dermatology unit in Florence with severe CHE refractory to potent topical corticosteroids. We evaluated the efficacy and safety of alitretinoin and we analyzed the response in the three months of follow-up in the group of patients who completed the cycle of therapy. Improvement in clinical signs and symptoms was assessed using mTLSS and PGA.
  
  
  METHODS
  All patients were treated daily with single 30-mg doses of oral alitretinoin for 3 to 5 months. The study examined 15 patients with a clinical diagnosis of severe CHE. We found the treatment to be efficient in nine of 13 patients (69%) who were assessed as having "clear" or "almost clear" hands according to PGA.
  
  
  CONCLUSIONS
  Even if the number of patients we analyzed was limited and lacked a control group the study allowed us to confirm the efficacy of alitretinoin used in a "real life" clinical experience. In addition, thanks to the adoption of proper emollient therapy and avoidance of any relevant allergens or irritants, no recurrence of the condition was observed among the patients who completed therapy with a PGA value of "mild", "almost clear", or "clear" during three months after treatment.
authors: Allergological and Occupational Dermatology Department of Surgery and Translational MedicineUniversity of Florence, Florence, Italy - massimo.gola@asf.toscana.it.
authors: M
authors: M
authors: Gola
authors: N
authors: N
authors: Milanesi
authors: A M
authors: AM
authors: D'Erme
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000077556:Alitretinoin; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004485:Eczema / Q000188:drug therapy* / Q000473:pathology; D004643:Emollients / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D003879:Dermatologic Agents; D004643:Emollients; D000077556:Alitretinoin; D014212:Tretinoin