Expert Consensus on Advanced Topical Nonsteroidal Therapies for Chronic Hand Eczema

Area of Science:

• Dermatology and immunology
• Inflammatory skin diseases
• Topical therapeutics

Background:

• Chronic hand eczema (CHE) is a prevalent condition causing significant symptom burden, functional impairment, and reduced quality of life.
• Limited evidence-based guidance exists for long-term, steroid-sparing topical management of CHE.
• CHE significantly impacts work productivity and daily functioning.

Purpose of the Study:

• To establish expert consensus on the role of advanced topical nonsteroidal therapies in managing chronic hand eczema.
• To provide guidance for the long-term, steroid-sparing treatment of CHE.

Main Methods:

• A panel of seven dermatologists conducted a structured literature review focusing on CHE-specific trials.
• Evidence was assessed using the Strength of Recommendation Taxonomy (SORT).
• Consensus statements were developed through a Delphi process, requiring at least 75% agreement.

Main Results:

• Six consensus statements were reached regarding advanced topical nonsteroidal therapies for CHE.
• Delgocitinib cream is the sole topical therapy with CHE-specific approval, recommended as a first-line advanced treatment.
• These therapies demonstrated rapid and sustained improvements in CHE symptoms (erythema, scaling, pruritus, pain) and patient-reported outcomes, including quality of life and work productivity.
• Favorable safety profiles were noted, with primarily local adverse events and no need for routine lab monitoring.

Conclusions:

• Expert consensus supports advanced topical nonsteroidal therapies as crucial steroid-sparing options for individualized CHE management.
• Delgocitinib cream is identified as a key first-line treatment option.
• Further research is needed to identify optimal use of other topical nonsteroidal agents in CHE.