A double-blind placebo-controlled trial of UVA-1 in the treatment of dyshidrotic eczema

Polderman, Marloes C. A.; Govaert, J C M; Cessie, Saskia le; Pavel, S.

doi:10.1046/j.1365-2230.2003.01378.x

Cited by 66 publications

(38 citation statements)

References 17 publications

(23 reference statements)

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“…14,15 Phototherapy with UVA-1 and UVB has been successfully used in the treatment of chronic hand eczema, but the inadequacy of evidence-based trials has limited its use. 16,17 Systemic oral immunosuppressants, such as azathioprine, ciclosporin, and mycophenolate mofetil, have also been used with various responses. However, most of these are not licensed for the treatment of chronic hand eczema, owing to the lack of clinical evidence supporting their lack of efficacy and safety.…”

Section: Managementmentioning

confidence: 99%

Update on the use of alitretinoin in treating chronic hand eczema

Ghasri¹,

Scheinfeld²

2010

CCID

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Abstract:Chronic hand eczema is a debilitating dermatological condition with significant economic, social, and functional impacts. To date, conventional treatments such as topical corticosteroids, phototherapy, and systemic immunosuppressants have yielded disappointing results, owing to either a lack of efficacy or significant adverse events. Oral alitretinoin (9-cis-retinoic acid) is a unique panagonist retinoid with immunomodulatory and antiinflammatory activity that has emerged as a novel treatment for chronic hand eczema. Several large-scale clinical studies have demonstrated oral alitretinoin's high efficacy rate of 28% to 89%, its safe tolerability profile, and its positive impact on quality of life, validating it as a therapeutic option for patients with severe chronic hand eczema refractory to standard treatment. Keywords: hand eczema, alitretinoin, 9-cisretinoic acid Chronic hand eczema BackgroundEczema is the most common dermatological disorder of the hands, with an annual prevalence of up to 12% and 16% in parts of Europe and the United States, respectively. 1,2Hand eczema is characterized by vesicles, papules, erythema, edema, scaling, fissures, and hyperkeratosis, as well as pruritic and painful symptoms.3,4 While there is no specific morphological classification system, clinical subtypes include vesicular, atopic, endogenous, discoid, acral, irritant, pompholyx, and hyperkeratotic eczema. 5Included in the differential diagnosis are irritant contact dermatitis, allergic contact dermatitis, endogenous eczema, psoriasis/pustulosis, fungal infection, keratoderma, lichen planus, and granuloma annulare. Hand eczema has a multi-factorial etiology, involving both endogenous and exogenous factors. 7 The primary endogenous predisposing factor is a history of atopy, which is the underlying etiology in as high as 50% of affected individuals.3 Genetic inheritance also plays a role, as demonstrated by a recent population-based twin cohort study.8 Exogenous factors primarily include exposure to irritants (ie, food, oils, soap, solvents), and contact allergens (ie, nickel, chromate, rubber). Occupational exposure to these causative agents, primarily among dressers, cooks, healthcare workers, for example, are the most common causes of hand eczema. 9 The interrelatedness of these etiologies renders it difficult to isolate and remove the offending agents, and is therefore a factor for development of hand eczema into a chronic, relapsing course.When hand eczema persists for more than 6 months despite therapeutic measures, it is considered to be a chronic form. 6 This variant of hand eczema develops in

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Section: Managementmentioning

confidence: 99%

Update on the use of alitretinoin in treating chronic hand eczema

Ghasri¹,

Scheinfeld²

2010

CCID

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“…Diese Therapie kann auch beim chronisch rezidivierenden dyshid rosen HE therapeutisch sehr effektiv ein gesetzt werden [2]. Die UVA1Photo therapie führte beim dyshidrosiformen HE zu einer Besserung der subjektiven und objektiven Beschwerden, wie in ei ner doppelblinden randomisierten pla cebokontrollierten Studie belegt wer den konnte [3]. In dieser Studie wurden 28 Patienten in eine Behandlungsgruppe [UVA1Phototherapie (40 J/cm 2 , 5mal pro Woche für 3 Wochen)] und in eine Placebogruppe randomisiert.…”

Section: Lokale Uva1phototherapie In Mittlerer Und Hoher Dosierung Beunclassified

New and rarley used treatment options for refractory hand eczema

et al. 2008

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Hand eczema (HE) is one of the most frequent skin diseases. HE has a wide spectrum, with variable etiology, severity, and morphology. It often displays a chronically relapsing course with a poor prognosis, and has a high impact on the quality of life. Although different treatment options exist, the management of patients with chronic HE is often unsatisfactory. We highlight new and rarely used approaches to treat chronic HE uncluding local UVA-1-phototherapy, retinoids including the new oral retinoid alitretinoin, and calcineurin inhibitors.

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“…UVA−1−Licht, einem langwelligen An− teil des ultravioletten Lichts, konnten Krutmann et al bei der Be− handlung der akut exazerbierten atopischen Dermatitis erzielen [9]. In den darauffolgenden Jahren wurde diese Therapie u. a. bei der Morphea [4,6,7], dem systemischen Lupus erythematodes [16], der Urtikaria pigmentosa [12] und nicht zuletzt beim dys− hidrosiformen Handekzem [14,15,19] . Gravierende Nebenwirkungen traten bei keiner der beiden The− rapieformen auf.…”

Section: Uva−1−therapieunclassified

“…Therapeu− tisch stehen neben allgemeinen Hautschutzmaß− nahmen v. a. symptomatisch wirksame Lokalbe− handlungen mit Glukokortikosteroiden im Vor− dergrund. Das Behandlungsspektrum umfasst weiterhin eine Vielzahl lichttherapeutischer Ver− fahren, die Pinsel−PUVA− [5], Bade−PUVA− [2,18], Creme−PUVA− [2,14], UVB− [1] und die UVA−1− Therapie [14,15,19]. Die Pinsel−PUVA−Therapie hat das Risiko unerwünschter phototoxischer Re− aktionen beim Abtropfen der Lösung.…”

unclassified

Mittel-Dosis-UVA-1- und lokale PUVA-Therapie beim dyshidrosiformen Handekzem - eine prospektive randomisierte Studie

Adams¹,

Bayerl²

2007

Akt Dermatol

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A double-blind placebo-controlled trial of UVA-1 in the treatment of dyshidrotic eczema

Cited by 66 publications

References 17 publications

Update on the use of alitretinoin in treating chronic hand eczema

Update on the use of alitretinoin in treating chronic hand eczema

New and rarley used treatment options for refractory hand eczema

Mittel-Dosis-UVA-1- und lokale PUVA-Therapie beim dyshidrosiformen Handekzem - eine prospektive randomisierte Studie

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