title: Methotrexate versus Acitretin in the Treatment of Chronic Hand Dermatitis.
abstract: BACKGROUND
  Recent studies have produced treatment algorithms for hand dermatitis, but there are limited current indications of systemic treatments for chronic hand dermatitis.
  
  
  OBJECTIVE
  To compare the efficacy and safety of methotrexate and acitretin in the treatment of chronic hand dermatitis.
  
  
  METHODS
  A chart-retrospective review of all patients with hand dermatitis seen by the primary author at the University of North Carolina Dermatology and Skin Cancer Center from September 2007 to April 2013.
  
  
  RESULTS
  Eighty-three hand dermatitis charts were reviewed. Twenty-nine patients received systemic therapy, of which 17 (26.5%) were treated systemically with acitretin and/or methotrexate. Of these 17 patients, four patients received courses of both acitretin and methotrexate independently after failing the alternative treatment course. At 6 months, acitretin achieved clearance/almost clearance in 44% of patients, compared to 0% of those treated with methotrexate. At 12 months, 100% of patients treated with acitretin achieved clearance/almost clearance compared to 40% of patients treated with methotrexate. Adverse effects were minimal and as expected.
  
  
  CONCLUSIONS
  This was a retrospective study, and the small sample size makes it difficult to generalize results.
  
  
  CONCLUSIONS
  Systemic retinoids are a good alternative for the treatment of chronic hand dermatitis.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: O'Shea
authors.forename: Aída
authors.initials: A
authors.lastname: Lugo-Somolinos
mesh_terms: D017255:Acitretin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D003879:Dermatologic Agents; D007641:Keratolytic Agents; D017255:Acitretin; D008727:Methotrexate