Hand Eczema Treatments That Help

Positive Results for Oral Medicine and a Treatment Combining Tanning Unit and Medication

From the WebMD Archives

Dec. 20, 2004 -- Seeking relief from the red, dry, cracked, and inflamed skin of hand eczema? Two new studies spotlight treatments that could help even the roughest cases.

Both studies were conducted in Europe on people with moderate to severe hand eczema, also called hand dermatitis. The results appear in the December issue of the Archives of Dermatology.

The first study tested an oral medicine called alitretinoin. It is similar to a medicine used to treat acne.

More than 300 people in 10 European countries enrolled. Their symptoms had lasted at least three months and hadn't responded well to standard therapy such as steroid creams.

Participants took a placebo pill or 10, 20, or 40 mg of alitretinoin once daily for 12 weeks. Alitretinoin outperformed the placebo across the board. The best results occurred at the highest dose.

At the end of 12 weeks, eczema symptoms completely disappeared or nearly vanished in slightly more than half of the group taking 40 mg of alitretinoin. The 20 mg dose was second best, followed by the 10 mg dose.

Alitretinoin was generally well tolerated at all levels. The most common side effects were headache, dry lip, flushing, and dry mouth.

The researchers included Thomas Ruzicka, MD, of Germany's Heinrich-Heine University Hospital. The journal notes that several scientists involved in the project had received grants, consultancy fees, or were employees of Basilea Pharmaceutica, the study's sponsor and alitretinoin's maker.

The second study took a different approach. It focused on home- vs. hospital-based treatment of a psoralen medication combined with use of a tanning unit.

Ultraviolet light is sometimes used to treat extreme eczema. A psoralen is given before the ultraviolet light. The treatment, called PUVA, is traditionally administered at a hospital.

Participants were more than 150 Dutch patients who had suffered moderate to severe hand eczema for at least a year. They were divided into two groups. One group was treated at a hospital; the other patients used a commercial, portable tanning device at home.

After 10 weeks, both groups showed similar and substantial decreases in eczema. The improvements were maintained for eight weeks.

The home-based group had two advantages. They missed less work for treatments and their travel costs were lower. That was expected, say the researchers, who included Dutch dermatologist A. Marco van Coevorden, MD, of University Hospital Groningen.

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SOURCES: Ruzicka, T. Archives of Dermatology, December 2004; vol 140: pp 1453-1459. van Coevorden, A. Archives of Dermatology, December 2004; vol 140: pp 1463-1466. WebMD Medical News: "Hand Dermatitis a Hazard for Massage Therapists." WebMD Medical Reference: "Understanding Eczema -- Treatment." News release, JAMA/Archives.
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