title: Oral Alitretinoin in the Treatment of Severe Refractory Chronic Hand Eczema in the Spanish National Health System: Description and Analysis of Current Clinical Practice.
abstract: OBJECTIVE
  Hand eczema affects nearly 10% of the population. The condition becomes severe and chronic in 5% to 7% of cases and is refractory to topical corticosteroids in 2% to 4%. This study aimed to describe the current use of oral alitretinoin in treating Spanish national health system patients with hand eczema that is refractory to potent topical corticosteroids.
  
  
  METHODS
  Observational, descriptive, exploratory, cross-sectional study based on the retrospective analysis of records for patients with hand eczema treated with alitretinoin in the Spanish national health system.
  
  
  RESULTS
  We reviewed the records for 62 patients in 13 hospitals in 5 different administrative areas (autonomous communities) of Spain. Alitretinoin was usually used at a dosage of 30mg/d. In most cases the physician judged the clinical response to be satisfactory after a single cycle. The recorded adverse effects were foreseeable and of the type reported for systemic retinoids. The dermatologists agreed that the clinical benefits achieved with alitretinoin favored adherence to treatment and an early return to work.
  
  
  CONCLUSIONS
  The results show that oral alitretinoin is being used according to established recommendations and that response is good, with few adverse effects. The dermatologists agreed that the benefits favored adherence and improved the patients' health related quality of life.
authors.affiliation: Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: S
authors.initials: S
authors.lastname: Urrutia
authors.affiliation: Servicio de Dermatología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
authors.forename: G
authors.initials: G
authors.lastname: Roustan
authors.affiliation: Departamento Médico, Almirall SA, Barcelona, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Plazas
authors.affiliation: Departamento Médico, Almirall SA, Barcelona, España.
authors.forename: S
authors.initials: S
authors.lastname: Armengol
authors.affiliation: Outcomes'10, Castellón, España. Electronic address: spaz@outcomes10.com.
authors.forename: S
authors.initials: S
authors.lastname: Paz
authors.affiliation: Outcomes'10, Castellón, España.
authors.forename: L
authors.initials: L
authors.lastname: Lizan
mesh_terms: D000077556:Alitretinoin; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004485:Eczema / Q000188:drug therapy*; D006229:Hand Dermatoses / Q000188:drug therapy*; D006801:Humans; D012189:Retrospective Studies; D013030:Spain; D014212:Tretinoin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000077556:Alitretinoin; D014212:Tretinoin
keywords: Alitretinoin; Alitretinoína; Chronic hand eczema; Eczema; Eczema crónico de manos; Patrones de práctica del médico; Physicians’ practice patterns