alitretinoin and Dermatitis--Occupational

Pompholyx is a chronic relapsing inflammatory vesicobullous skin disease of the hands and feet belonging to the spectrum of eczema. Established treatments, both topical and systemic, are limited in efficacy, risk:benefit ratio and prevention of further relapses. New treatment options are needed.. The article will discuss new treatment options, in particular for cheiropompholyx.. A MEDLINE and ClinicalTrials.gov research has been conducted and publications about new and emerging treatments for pompholyx have been analysed.. Among the recent developments, topical calcineurin inhibitors (TCI) and botulinum toxin A (BTXA) seem to be effective against pompholyx. The major disadvantage of BTXA is the need for injections, but efforts are being made to develop a topical form of application. Bexaroten gel has been used for chronic hand dermatitis, with good efficacy in the hyperkeratotic type. Further studies on pompholyx are needed. There is currently widespread interest in plant-based pharmaceuticals. Studies involving such topical drugs are on the way. In systemic treatment, retinoid alitretinoin has been most extensively studied in hand dermatitis. However, experiences relating to pompholyx are more limited. New types of anti-inflammatory oral drugs such as leukotriene inhibitors and phosphodiesterase-4 (PDE4) inhibitors have become available. These seem to have potential in the adjuvant treatment of pompholyx. Monoclonal antibodies of various types have been investigated in small series, but have failed to demonstrate consistent efficacy. Further investigations with new monoclonals are needed. Phototherapy of pompholyx is a cornerstone in treatment. High-dose UVA1 has been established as an effective modality in centres where the rather expensive equipment is available. Recently, UV-free phototherapy has been introduced, but more data are needed before final conclusions can be drawn.

Topics: Administration, Topical; Adolescent; Adult; Alitretinoin; Anti-Inflammatory Agents; Antibodies, Monoclonal; Botulinum Toxins, Type A; Calcineurin Inhibitors; Child; Clinical Trials as Topic; Dermatitis, Occupational; Double-Blind Method; Drug Design; Eczema, Dyshidrotic; Humans; Immunosuppressive Agents; Leukotriene Antagonists; Multicenter Studies as Topic; Phosphodiesterase Inhibitors; Photochemotherapy; PUVA Therapy; Recurrence; Tretinoin

Patients taking part in a tertiary individual prevention program (TIP) for work-related skin diseases frequently have chronic hand eczema (HE) for which alitretinoin is a treatment option.. To investigate treatment with alitretinoin before and during the TIP and related factors.. Data of 1614 patients taking part in the TIP between January 2015 and December 2019 were analyzed retrospectively.. Three hundred forty-eight patients (21.6%) reported treatment with alitretinoin prior to the TIP showing an increase over time, particularly in men. In 45 patients (2.8%), alitretinoin treatment was initiated during the TIP. Treatment with alitretinoin was significantly less common among female than male patients, both prior to (P < .001) and during the TIP (P = .015). Female patients who had received alitretinoin in the past were significantly older than the other female patients (P < .001). Among patients treated with alitretinoin prior to the TIP, women had a significantly higher disease severity at admission than men (P = .007).. About twenty percent of patients reported treatment with alitretinoin prior to the TIP. The data indicate that treatment of female TIP patients with alitretinoin is less frequent than among male patients and depends on age and disease severity.

Topics: Adolescent; Adult; Age Factors; Aged; Alitretinoin; Dermatitis, Occupational; Dermatologic Agents; Female; Hand Dermatoses; Humans; Male; Middle Aged; Retrospective Studies; Severity of Illness Index; Young Adult

Topics: Adult; Alitretinoin; Cosmetics; Dermatitis, Allergic Contact; Dermatitis, Occupational; Dermatologic Agents; Detergents; Hand Dermatoses; Humans; Male; Occupational Health; Paint; Patch Tests; Pruritus; Recurrence; Secondary Prevention; Steroids; Thiazoles; Treatment Outcome

Topics: Alitretinoin; Dermatitis, Allergic Contact; Dermatitis, Occupational; Dermatologic Agents; Gardening; Hand Dermatoses; Humans; Male; Middle Aged; Tretinoin

Topics: Adult; Alitretinoin; Animal Husbandry; Animals; Dermatitis, Occupational; Dermatologic Agents; Female; Foot Dermatoses; Hand Dermatoses; Horses; Humans; Tretinoin

Topics: Adult; Alitretinoin; Dermatitis, Occupational; Dermatologic Agents; Eczema, Dyshidrotic; Hand Dermatoses; Humans; Male; Tretinoin