Treatment of Moderate to Severe Dyshidrotic Hand Eczema
Dyshidrotic eczema affecting the hands can progress to moderate or severe disease. At this level, foundational first-step measures are insufficient on their own, and a structured step-up treatment approach becomes necessary.
This protocol addresses adults with moderate to severe hand eczema (dyshidrotic eczema) in whom basic measures have not provided adequate disease control.
Treatment approach
The step-up regimen for this severity level incorporates specific classes of topical therapies and may also include light-based treatment modalities — with further options available depending on response. The complete selection criteria, sequencing, and parameters are set out in the full protocol.
References
DOI: 10.1111/ddg.15179
- In addition to measures of step 1: topical glucocorticoids (class II-IV, short-term, also class IV); UV therapy; alitretinoin.
- In adult patients with moderate to severe CHE refractory to topical glucocorticoids, phototherapy (topical PUVA, narrowband UVB, UVA1) should be performed.
- Alitretinoin shall be used in patients with moderate to severe CHE, if topical and/or phototherapy alone are not sufficiently effective.
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