Guidelines for diagnosis, prevention and treatment of hand eczema
- 27 January 2015
- journal article
- review article
- Published by Wiley in JDDG: Journal der Deutschen Dermatologischen Gesellschaft
- Vol. 13 (1), e1-e22
- https://doi.org/10.1111/ddg.12510_1
Abstract
The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence‐ and consensus‐based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand‐searching). In addition to the evidence‐ and consensus‐based recommendation on the treatment of HE, the guidelines cover mainly consensus‐based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non‐pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long‐term treatment beyond six weeks only when necessary and under careful medical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head‐to‐head” RCTs are needed. The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medical Societies in Germany). No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest.Keywords
This publication has 104 references indexed in Scilit:
- Immediate and delayed allergic hypersensitivity to corticosteroids: practical guidelinesContact Dermatitis, 2011
- Hand eczema classification: a cross-sectional, multicentre study of the aetiology and morphology of hand eczemaBritish Journal of Dermatology, 2009
- Medical consultations in relation to severity of hand eczema in the general populationBritish Journal of Dermatology, 2008
- Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trialBritish Journal of Dermatology, 2008
- Cyclosporin in the treatment of patients with atopic eczema – a systematic review and meta‐analysisJournal of the European Academy of Dermatology and Venereology, 2007
- Incidence of hand eczema in female Swedish hairdressersOccupational and Environmental Medicine, 2007
- Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitisNature Genetics, 2006
- A systematic review of contact dermatitis treatment and preventionJournal of the American Academy of Dermatology, 2005
- Fifteen-Year Follow-Up of Hand Eczema: Predictive FactorsJournal of Investigative Dermatology, 2005
- Short-Term Glucocorticoid Treatment Compromises Both Permeability Barrier Homeostasis and Stratum Corneum Integrity: Inhibition of Epidermal Lipid Synthesis Accounts for Functional AbnormalitiesJournal of Investigative Dermatology, 2003