title: Open-label exploratory study of acitretin for the treatment of severe chronic hand dermatitis.
abstract: BACKGROUND
  Acitretin is a retinoid approved for the treatment of psoriasis that has good efficacy for palmoplantar psoriasis. The safety and efficacy of acitretin in severe chronic hand dermatitis (CHD) is unknown.
  
  
  METHODS
  A total of nine patients with severe CHD were enrolled and treated with acitretin 10 mg once daily which could be increased to 30 mg daily if well-tolerated. Patients were treated for up to 24 or 12 weeks if the physician global assessment (PGA) was clear or almost clear at that time. CHD severity was evaluated using a 5-grade PGA scale and the modified total lesion symptom score (mTLSS).
  
  
  RESULTS
  The proportion of patients achieving PGA of clear or almost clear was 33.3% (95% CI: 9-69%) and the proportion achieving PGA of clear, almost clear or mild was 44% (95% CI: 15-77%). The mTLSS decreased by 45% (-6.3 ± 4.7; p = 0.02). Three patients did not complete the study: one due to an increase in facial dermatitis, one due to lack of efficacy and one who withdrew consent.
  
  
  CONCLUSIONS
  This pilot study suggests that acitretin could improve severe CHD. Further studies are needed to better assess the efficacy and safety of acitretin in patients with severe CHD.
authors.affiliation: Windsor Clinical Research Inc ., Windsor , Canada and.
authors.forename: Jerry
authors.initials: J
authors.lastname: Tan
authors.forename: Catherine
authors.initials: C
authors.lastname: Maari
authors.forename: Simon
authors.initials: S
authors.lastname: Nigen
authors.forename: Chantal
authors.initials: C
authors.lastname: Bolduc
authors.forename: Robert
authors.initials: R
authors.lastname: Bissonnette
mesh_terms: D017255:Acitretin / Q000627:therapeutic use*; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000627:therapeutic use*; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D010865:Pilot Projects; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D017255:Acitretin
keywords: Alitretinoin and hand eczema; palmoplantar; retinoid