Delgocitinib Cream for Chronic Hand Dermatitis: Efficacy, Safety and Clinical Application

Chronic hand dermatitis (CHD), also referred to as chronic hand eczema, is a persistent inflammatory skin disorder characterized by erythema, fissuring, scaling, lichenification, and significant pruritus and pain. The condition is often debilitating, particularly because the hands are constantly exposed to mechanical friction, detergents, irritants, and environmental stressors. Traditional treatments such as topical corticosteroids, calcineurin inhibitors, phototherapy, and systemic immunomodulators are limited by safety concerns, incomplete efficacy, or poor long-term tolerability. Delgocitinib 2% cream, a non-steroidal, topical pan-Janus kinase (JAK) inhibitor, represents the first targeted therapy specifically approved for moderate-to-severe CHD in adults. Through inhibition of JAK1, JAK2, JAK3, and tyrosine kinase 2, delgocitinib broadly suppresses multiple cytokine pathways involved in hand eczema pathogenesis. Clinical trials have demonstrated significant improvement in Investigator's Global Assessment scores, Hand Eczema Severity Index, pruritus, pain, and quality of life, along with sustained benefit in long-term extension studies. Safety data reveal minimal systemic absorption, no steroid-associated skin atrophy, and a favorable tolerability profile without box warnings. This review examines the pathophysiology of CHD and the clinical evidence supporting delgocitinib as an effective, steroid-sparing therapeutic option.