[Traditional and innovative treatment approaches in occupational dermatology]

The present article deliberately refrains from merely reproducing existing therapeutic guidelines; instead, it focuses on describing and presenting both traditional and innovative treatments for hand dermatoses from the perspective of an occupational dermatology referral centre, while taking current therapeutic guidelines into account. In occupational dermatology, hand dermatoses-particularly hand eczema-constitute the majority of diagnosed and treated skin diseases. Despite their high prevalence, comprehensive evidence-based therapeutic guidelines for hand dermatoses are lacking; consequently, clinical practice relies heavily on long-standing experiential knowledge. Dermatologists providing care for occupational skin diseases under the statutory health insurance (SGB VII) are permitted to employ "all appropriate measures" within the scope of the treatment mandate. All such interventions are embedded in a coordinated prevention programme, which, in addition to therapy, includes outpatient skin-protection seminars and individualized inpatient prevention. Treatment algorithms now integrate classic topical measures with systemic options; the modern approach aims to replace glucocorticoid monotherapy with a differentiated, evidence-based, patient-centred pharmacotherapy that considers chronicity, comorbidities, and individual preferences.