New and rarley used treatment options for refractory hand eczema

Raap, Ulrike; Kenneweg, C.; Kapp, Alexander; Werfel, T.

doi:10.1007/s00105-008-1561-8

Cited by 11 publications

(3 citation statements)

References 17 publications

(11 reference statements)

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“…UVA1 phototherapy has the practical advantage of eliminating the need to apply a cream to the hands and feet before irradiation and the need for constant light protection after irradiation. Another study [ 48 ] compared the therapeutic effect of UVA1 phototherapy at high and low doses in 27 patients (9 men and 18 women) with dyshidrotic eczema of the hands ( n = 18) and feet ( n = 9). The cumulative light dose was 730 J/cm 2 in the low-dose range and 1720 J/cm 2 in the high-dose range, with irradiation performed five times per week for 3 weeks.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Satisfaction of Low Doses UVA1 Phototherapy: A Spanish Experience from a Single Centre

Velasco-Amador

Linares‐González

Gomar

2023

Life

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Background: UVA1 phototherapy is a treatment used for multiple dermatological conditions. The optimal therapeutic regimens and dosing of UVA1 are a matter of debate. The dosages used vary widely between published studies and there are no evidence-based protocols that provide data on dosage, duration, or the role of maintenance therapy. The purpose of this study is to evaluate the experience in our medical center regarding treatment with UVA1, as well as the degree of patient satisfaction with the treatment according to their pathology. Methods: We present a retrospective evaluation of outcomes, treatment tolerability, and satisfaction in adult patients using a low dose of UVA1 phototherapy, administered in our dermatologic service between 2019 and 2022. Results: A total of 78 patients were treated with UVA1, of whom 46 patients (59%) were over 18 years old, completed treatment, and gave their consent. The overall objective clinical response rate was 91.30% (42/46), achieving a complete response in 17 (36.96%) patients, partial response in 25 (54.34%), and no response in 4 (8.70%). The complete response rates recorded were high in morphea, scleredema, or chronic hand eczema. In terms of the level of satisfaction objectively measured by TSQM-9 version 1.4, highlighting high scores obtained in mastocytosis, systemic sclerosis, morphea, scleredema, chronic hand eczema, or prurigo nodularis (over 65 points). Conclusions: We present a review of treatment with UVA1 phototherapy at low doses with good response in a wide variety of dermatological pathologies.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Satisfaction of Low Doses UVA1 Phototherapy: A Spanish Experience from a Single Centre

Velasco-Amador

Linares‐González

Gomar

2023

Life

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“…Current existing therapies include topical or systemic treatments, avoidance of the exposed irritants by gloves, educational programmes and lifestyle changes [7,29-31]. Local phototherapy, and off-label use of retinoids, calcineurin inhibitors, immune suppressants such as systemic steroids and ciclosporin are alternative escalation steps for those who do not respond adequately to standard care including topical steroids [32]. …”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of oral alitretinoin in patients with severe chronic hand eczema - a long-term analysis from a Swiss perspective

Blank

Blank²,

Szucs

2010

BMC Dermatol

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BackgroundThe impact on patients suffering from chronic hand eczema (CHE) is enormous, as no licensed systemic treatment option with proven efficacy for CHE is available. Alitretinoin is a novel agent which showed high clinical efficacy in patients with severe, refractory CHE. We assessed the cost-effectiveness of alitretinoin for CHE patient treatment from a Swiss third party payer perspective. A further objective of this study was to determine the burden of disease in Switzerland.MethodsA long-term Markov cohort simulation model was used to estimate direct medical costs (€) and clinical effectiveness (quality adjusted life years, QALYs) of treating severe CHE patients with alitretinoin. Comparison was against the standard treatment of supportive care (optimised emollient therapy). Information on response rates were derived from a randomized controlled clinical trial. Costs were considered from the perspective of the Swiss health system. Swiss epidemiological data was derived from official Swiss Statistic institutions.ResultsAnnual costs of alitretinoin treatment accounted for €2'212. After a time horizon of 22.4 years, average remaining long-term costs accounted for €42'208 or €38'795 in the alitretinoin and the standard treatment arm, respectively. Compared with the standard therapy, the addition of alitretinoin yielded an average gain of 0.230 QALYs at the end of the simulation. Accordingly, the incremental cost-effectiveness ratio resulted in €14'816/QALY gained. These results were robust to changes in key model assumptions.ConclusionThe therapy for CHE patients is currently insufficient. In our long-term model we identified the treatment with alitretinoin as a cost-effective alternative for the therapy of CHE patients in Switzerland.

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“…Orale Retinoide sind zur Behandlung schwerer und chronischer Ekzeme indiziert [24,37]. Während der Einsatz von Acitretin oftmals durch die Nebenwirkungen begrenzt wird, konnte mit Alitretinoin eine ausgesprochen gute Wirksamkeit mit einer fast vollständigen Abheilung bei 48% der Patienten und deutlich geringerem Nebenwirkungsprofil festgestellt werden.…”

Section: Infobox 1 Tertiäre Individualprävention -Indikationenunclassified

Rehabilitation bei Berufsdermatosen

2010

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In recent years, the number of reports of suspicions of occupational diseases, received by the public statutory employer's liability insurance bodies, has remained constant. The recognition of occupational diseases under number 5101 BKV, however, has decreased considerably. This is more than likely due to improved prevention management concepts by the public statutory employer's liability insurance bodies. Nevertheless there are still severe occupational skin diseases that are resistant to or relapse under therapy, thus threatening discontinuation of the occupation. For these cases, an interdisciplinary inpatient treatment as a tertiary individual prevention measure was introduced. This consists of a three-week inpatient period followed by a three-week outpatient sick leave for further stabilization of the skin condition. During the inpatient stay intensive dermatological diagnosis and treatment are accompanied by in-depth health education seminars and psychological interventions. The selection of individually suitable skin protection measures and their practical trial in a workplace simulation model with an ergotherapist are of particular importance. Evaluations of this program showed that two-thirds of the participants with the defined risk of having to give up their occupation were able to continue with their occupation on a long-term basis.

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New and rarley used treatment options for refractory hand eczema

Cited by 11 publications

References 17 publications

Efficacy and Satisfaction of Low Doses UVA1 Phototherapy: A Spanish Experience from a Single Centre

Efficacy and Satisfaction of Low Doses UVA1 Phototherapy: A Spanish Experience from a Single Centre

Cost-effectiveness of oral alitretinoin in patients with severe chronic hand eczema - a long-term analysis from a Swiss perspective

Rehabilitation bei Berufsdermatosen

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