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Physician-Reported Treatment Patterns in Moderate to Severe Chronic Hand Eczema: the RWEAL Multinational Medical

Ana Giménez-Arnau¹, Anthony Bewley², Christian Apfelbacher³

¹Department of Dermatology, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Passeig Maritim de la Barceloneta 25-29, 08003, Barcelona, Spain. anamariagimenezarnau@gmail.com.

Dermatology and Therapy

|September 26, 2025

Summary

Many patients with chronic hand eczema (CHE) show inadequate response or contraindication to topical corticosteroids (TCS). Over a quarter of these patients require progression to phototherapy or systemic therapies, indicating a need for better topical treatments.

Keywords:

Chronic hand eczema Contact dermatitis Real-world evidence Topical corticosteroids Treatment patterns

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Area of Science:

Dermatology
Clinical Research
Pharmacology

Background:

Chronic hand eczema (CHE) is a common condition with limited evidence for effective treatments in clinical practice.
Topical corticosteroids (TCS) are a first-line treatment, but many patients experience inadequate response or contraindications.

Purpose of the Study:

To investigate treatment patterns in adult patients with moderate to severe CHE.
To analyze treatment choices for patients with inadequate response or contraindications to TCS.

Main Methods:

Multinational retrospective physician chart review across Canada, France, Germany, Italy, Spain, and the UK.
Data collected on adult patients with moderate to severe CHE treated with TCS in the past 12 months or for whom TCS were contraindicated.

Main Results:

Nearly 40% of patients with CHE had an inadequate response or contraindication to TCS.
Over 27% of these patients progressed to phototherapy or systemic treatments.
Biologics, alitretinoin, and traditional oral therapies were common subsequent treatments for inadequately managed CHE.

Conclusions:

A significant proportion of moderate to severe CHE patients are inadequately treated with first-line TCS.
The progression to phototherapy or systemic therapy highlights the need for more effective and well-tolerated topical treatment options for CHE.
Current treatment strategies may not fully address the needs of patients with chronic hand eczema.