Treatment of severe, chronic hand eczema: results from a UK-wide survey

I L Smith; S Brown; J Nixon; F C Cowdell; S Ersser; C Fernandez; M Goodfield; C M Green; P Hampton; J T Lear; C H Smith; L Sunderland; S Tubeuf; M Wittmann

doi:10.1111/ced.13015

Treatment of severe, chronic hand eczema: results from a UK-wide survey

I L Smith, S Brown, J Nixon, F C Cowdell, S Ersser, C Fernandez, M Goodfield, C M Green, P Hampton, J T Lear, C H Smith, L Sunderland, S Tubeuf, M Wittmann

Dermatology

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Treatment of severe hand eczema (HE) that is resistant to topical potent corticosteroid treatment is challenging. In 2013, we surveyed 194 UK dermatologists to obtain information about their usual treatment pathways to inform the choice of the comparator in a trial of alitretinoin in severe HE (ALPHA trial); the results indicated that the treatment approaches favoured by UK dermatologists differ. Psoralen combined with ultraviolet A (PUVA) and alitretinoin were identified as the most frequent first-line treatment options for hyperkeratotic HE, whereas oral corticosteroids were identified as the most frequent first-line treatment for vesicular HE, followed by PUVA and alitretinoin. In terms of potential adverse effects of long-term or repeated use, oral steroids and ciclosporin A were reported to cause most concern. There is uncertainty about which treatment gives the best short and long-term outcomes, because of a lack of definitive randomised controlled trials evaluating the effectiveness of different treatment pathways in severe HE.

Original language	English
Pages (from-to)	185-188
Number of pages	4
Journal	Clinical and Experimental Dermatology
Volume	42
Issue number	2
DOIs	https://doi.org/10.1111/ced.13015
Publication status	Published - Mar 2017

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title = "Treatment of severe, chronic hand eczema: results from a UK-wide survey",

abstract = "Treatment of severe hand eczema (HE) that is resistant to topical potent corticosteroid treatment is challenging. In 2013, we surveyed 194 UK dermatologists to obtain information about their usual treatment pathways to inform the choice of the comparator in a trial of alitretinoin in severe HE (ALPHA trial); the results indicated that the treatment approaches favoured by UK dermatologists differ. Psoralen combined with ultraviolet A (PUVA) and alitretinoin were identified as the most frequent first-line treatment options for hyperkeratotic HE, whereas oral corticosteroids were identified as the most frequent first-line treatment for vesicular HE, followed by PUVA and alitretinoin. In terms of potential adverse effects of long-term or repeated use, oral steroids and ciclosporin A were reported to cause most concern. There is uncertainty about which treatment gives the best short and long-term outcomes, because of a lack of definitive randomised controlled trials evaluating the effectiveness of different treatment pathways in severe HE.",

author = "Smith, {I L} and S Brown and J Nixon and Cowdell, {F C} and S Ersser and C Fernandez and M Goodfield and Green, {C M} and P Hampton and Lear, {J T} and Smith, {C H} and L Sunderland and S Tubeuf and M Wittmann",

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doi = "10.1111/ced.13015",

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TY - JOUR

T1 - Treatment of severe, chronic hand eczema

T2 - results from a UK-wide survey

AU - Smith, I L

AU - Brown, S

AU - Nixon, J

AU - Cowdell, F C

AU - Ersser, S

AU - Fernandez, C

AU - Goodfield, M

AU - Green, C M

AU - Hampton, P

AU - Lear, J T

AU - Smith, C H

AU - Sunderland, L

AU - Tubeuf, S

AU - Wittmann, M

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AB - Treatment of severe hand eczema (HE) that is resistant to topical potent corticosteroid treatment is challenging. In 2013, we surveyed 194 UK dermatologists to obtain information about their usual treatment pathways to inform the choice of the comparator in a trial of alitretinoin in severe HE (ALPHA trial); the results indicated that the treatment approaches favoured by UK dermatologists differ. Psoralen combined with ultraviolet A (PUVA) and alitretinoin were identified as the most frequent first-line treatment options for hyperkeratotic HE, whereas oral corticosteroids were identified as the most frequent first-line treatment for vesicular HE, followed by PUVA and alitretinoin. In terms of potential adverse effects of long-term or repeated use, oral steroids and ciclosporin A were reported to cause most concern. There is uncertainty about which treatment gives the best short and long-term outcomes, because of a lack of definitive randomised controlled trials evaluating the effectiveness of different treatment pathways in severe HE.

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DO - 10.1111/ced.13015

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JO - Clinical and Experimental Dermatology

JF - Clinical and Experimental Dermatology

IS - 2

ER -

Treatment of severe, chronic hand eczema: results from a UK-wide survey

Abstract

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