Efficacy and Safety of a Retinoid in the Treatment of Severe Chronic Hand Eczema

Chronic hand eczema (CHE)is a distressing disease that poses difficult problems for
dermatologists. CHE leads to considerable work-absenteeism, disability and exclusion from
labour market. Conventional treatments, including highly potent topical steroids, yield often
unsatisfactory results. This study investigates the efficacy and safety of oral alitretinoin,
a retinoid, in patients who have not responded to avoidance of causative factors, such as
contact allergens and skin irritants, non-medicated skin care and highly potent topical
steroids. Eligible patients are randomly assigned to receive alitretinoin or a placebo.

Inclusion Criteria:

- all types of chronic hand eczema, lasting for at least 6 months since initial
diagnosis

- rated as severe by the physician

- unresponsive to highly potent topical corticosteroids, such as clobetasol

Exclusion Criteria:

- patients whose disease is adequately controlled by standard non-medicated therapy,
including potent topical steroids, skin moisturizers, and avoidance of allergens and
irritants

- patients with known allergens and irritants, who have not made a reasonable effort to
avoid the substances

- patients with psoriasis lesions

- active fungal, bacterial or viral infections of the hands

- female patients who are pregnant or breastfeeding

- female patients of childbearing potential who cannot use or will not commit to use two
effective methods of contraception