Long-term, intermittent treatment of chronic hand eczema with mometasone furoate

Abstract

Chronic hand eczema can be incapacitating, and there is little knowledge of the efficacy and safety of long-term treatment with topical corticosteroids. We compared the efficacy and safety of two different schedules for the treatment of chronic hand eczema with a potent topical corticosteroid, mometasone furoate. In a prospective, open, randomized trial, 120 patients with chronic hand eczema were treated daily with mometasone furoate fatty cream until the dermatitis cleared or for a maximum of 9 weeks. Those who cleared were randomized to treatment for up to 36 weeks with mometasone furoate on Sunday, Tuesday and Thursday (group A), mometasone furoate on Saturday and Sunday (group B) or no further corticosteroid treatment (group C). In the event of relapse, patients were permitted daily treatment with mometasone furoate for 3 weeks on two separate occasions. For 50 of 106 randomized patients, daily treatment for 3 weeks controlled their dermatitis; 29 needed 6 weeks and 27 needed 9 weeks of treatment. During the maintenance phase, 29 of 35 (83%) in group A, 25 of 37 (68%) in group B and nine of 34 (26%) in group C had no recurrences (P = 0.001, chi2-test). Side-effects were minimal. It is concluded that long-term, intermittent treatment of chronic hand eczema with mometasone furoate fatty cream is effective and safe.

Comparative safety and efficacy of topical mometasone furoate with other topical corticosteroids

“…However, mometasone furoate 0.1% cream was found to have similar efficacy to clobetasone butyrate 0.05% in children with mixed dermatoses 34. In further studies it was shown that a regimen of mometasone furoate 0.1% cream applied 2 or 3 days/week for up to 36 weeks, and 2 days/week for 26 weeks was prophylactic in both adults with eczema35 and children with atopic dermatitis 36. Recently, new cream formulations of mometasone furoate have become available, which have been shown to be bioequivalent to the older preparations 7, 37, 38, 39…”

Hand Eczema

“…30 However, skin atrophy is a risk of prolonged treatment with glucocorticoids. The American Academy of Dermatology recommends daily use for 1 month followed by maintenance therapy two to three times per week.…”

Update on Hand Eczema with Special Focus on the Impact of Moisturisers

“…These agents are very effective in the short term, but they inhibit repair of the stratum corneum and may interfere with recovery in the long term. There is some evidence for long-term intermittent treatment of chronic hand eczema with mometasone furoate cream [ 61 ] . The adverse effects of topical steroids include cutaneous atrophy, tachyphylaxis and adrenal suppression after systemic absorption.…”