Guidelines for diagnosis, prevention and treatment of hand eczema

Area of Science:

• Dermatology
• Clinical Guidelines
• Evidence-Based Medicine

Background:

• Hand eczema (HE) is a common condition requiring clear management strategies.
• Existing treatment protocols vary, necessitating standardized, evidence-based recommendations.
• The European Society of Contact Dermatitis (ESCD) identified a need for updated HE management guidelines.

Purpose of the Study:

• To establish comprehensive, evidence- and consensus-based guidelines for the diagnosis, prevention, and treatment of hand eczema (HE).
• To synthesize findings from a systematic Cochrane review on HE interventions.
• To provide clear recommendations for optimal current practice in HE management.

Main Methods:

• Systematic literature review, including a Cochrane review on HE interventions.
• Evidence and consensus-based approach involving a working group of the European Society of Contact Dermatitis (ESCD).
• Inclusion of diagnostic aspects, primary and secondary prevention, and treatment strategies (non-pharmacological, topical, physical, systemic).

Main Results:

• Topical corticosteroids are recommended as the first-line treatment for hand eczema (HE).
• Long-term topical corticosteroid use beyond six weeks requires medical supervision.
• Alitretinoin is recommended as a second-line systemic treatment for severe chronic HE.
• Further randomized control trials (RCTs) are needed for other systemic treatments and head-to-head comparisons.

Conclusions:

• The guidelines offer a structured approach to managing hand eczema (HE) based on the best available evidence and expert consensus.
• Current recommendations prioritize topical corticosteroids and alitretinoin for severe cases.
• Future research should focus on comparative studies of systemic treatments for HE.