Current and emerging therapies for hand eczema

Area of Science:

• Dermatology
• Immunology
• Pharmacology

Background:

• Hand eczema (HE) and chronic hand eczema (CHE) are prevalent dermatoses with substantial disease burden.
• Traditional treatments, primarily topical and short-term systemic corticosteroids, offer limited efficacy.
• A lack of standardized classification for HE subtypes hinders treatment development.

Purpose of the Study:

• To review current and emerging topical and systemic therapeutic agents for HE and CHE.
• To discuss the etiologies of HE subtypes and identify knowledge and practice gaps.
• To encourage further research into novel treatment strategies for HE and CHE.

Main Methods:

• Comprehensive literature search of ClinicalTrials.gov and PubMed for relevant clinical trials.
• Review of published and preliminary evidence on established and novel therapeutic agents.
• Analysis of agents targeting key pathways in CHE pathogenesis, including IL-4/IL-13 signaling and inflammatory mediators.

Main Results:

• Several systemic agents (e.g., dupilumab, alitretinoin) and topical agents (e.g., delgocitinib, retapamulin) show varying clinical efficacy.
• Agents targeting IL-4/IL-13 signaling, keratinocyte proliferation, and inflammatory mediators are implicated in CHE pathogenesis.
• Despite emerging targeted therapies, treatment options for HE remain limited due to its heterogeneous nature.

Conclusions:

• Targeted therapies are emerging for HE, but treatment options are still restricted.
• A deeper understanding of HE's heterogeneity is crucial for developing effective, targeted treatments.
• Additional and specialized therapeutic options are necessary to address the increasing prevalence and burden of HE.