Alitretinoin for the treatment of severe chronic eczema of the hands

Introduction: Chronic hand eczema (CHE) is a frequent skin disorder affecting up to 10% of the population and strongly reduces Quality of Life (QoL). The first-line therapeutic strategies for the management of CHE include a change of lifestyle, an education program for the skin and the application of specific emollients. Topical corticosteroids or calcineurin inhibitors are the most used antiinflammatory drugs. However, up to 65% of patients require systemic options. Alitretinoin, a retinoid structurally related to vitamin A, is the first systemic treatment approved in the European Union (EU) for severe CHE refractory to potent topical corticosteroids. Areas covered: This review summarizes the available data on the pharmacokinetics, pharmacodynamics, efficacy, and safety profile of oral alitretinoin for the treatment of CHE. Expert opinion: Alitretinoin can be considered as a valid therapeutic option for the treatment of CHE in patients not responding to ordinary treatments. Clinical trials and real-life experiences showed that it acts effectively on both objective and subjective clinical signs, resulting in a significant improvement in QoL of patients. As for other retinoids, caution should be taken in patients with certain chronic diseases (hepatopathies, kidney failure, hyperlipidemia, thyroid dysfunction) or childbearing potential women.

Automated summary

Alitretinoin can be considered as a valid therapeutic option for patients with Chronic Hand Eczema who do not respond to conventional treatments. Clinical trials and real-life experiences have shown that it effectively improves both objective and subjective clinical symptoms, leading to a significant enhancement in patients' Quality of Life. Prior caution should be exercised in patients with certain chronic diseases or women of childbearing age when prescribing alitretinoin.