Efficacy and Safety of Topical 1.5% Ruxolitinib for Chronic Hand Eczema in Real‑World Practice

Chronic hand eczema (CHE) is defined as hand eczema persisting for >3 months or recurring at least twice within 12 months and is associated with significant pruritus, pain, functional impairment, and psychosocial burden. Conventional treatments are frequently inadequate or limited by adverse events (AEs). Topical Janus kinase inhibitors represent a novel therapeutic option. While delgocitinib has recently been approved for CHE, emerging evidence suggests topical ruxolitinib may also be effective.

To evaluate the real-world efficacy and safety of topical ruxolitinib 1.5% cream in patients with moderate-to-severe CHE.

This retrospective real-world case series included 13 patients with CHE treated with ruxolitinib 1.5% cream applied twice daily for ~12 weeks. Baseline demographic and clinical characteristics were collected, including CHE subtype and disease severity. Treatment response was assessed using the Physician's Global Assessment (PGA).

The cohort included 8 females and 5 males with a mean age of 33.8 years and mean disease duration of 6.9 years. Most patients had hyperkeratotic CHE (76.9%), with all exhibiting moderate-to-severe disease at baseline (PGA 3-4). By week 12, 92.3% of patients achieved a PGA score of 0 or 1, indicating clear or almost clear disease. No treatment-related AEs were reported during follow-up.

Topical ruxolitinib demonstrated high rates of clinical improvement and favorable tolerability in this real-world CHE cohort. Despite limitations including small sample size and retrospective design, these findings support ruxolitinib as a promising option for recalcitrant CHE and warrant confirmation in larger randomized controlled trials.