Oral drug curbs chronic hand dermatitis

Alitretinoin, a pill, reduces the symptoms of chronic hand dermatitis that doesn't respond to conventional therapy, German researchers report.

"Few effective treatment options are available for patients who do not respond adequately to (steroid creams) and whose disease severely impairs social and professional life," the authors point out in the Archives of Dermatology.

Encouraged by the results of an pilot study of alitretinoin in 38 patients, Dr. Thomas Ruzicka from Heinrich-Heine University Hospital, Dusseldorf and colleagues conducted a another trial involving 319 patients with chronic hand dermatitis that had not improved after at least four weeks' use of corticosteroid creams.

The severity and extent of dermatitis decreased significantly among patients treated with oral alitretinoin, the authors report, and the reductions in symptom scores were significantly more marked with all doses of alitretinoin than with placebo.

Response rates depended on alitretinoin dose for all types of chronic hand dermatitis, the report indicates, regardless of initial disease severity.

Just over half the patients treated with the highest dose (40 milligrams per day) saw complete or almost complete disappearance of dermatitis. However, 10 percent to 20 percent of patients had no improvement, even at the highest dose.

"The encouraging results of this trial," Ruzicka's team concludes, "support further clinical studies of alitretinoin in the treatment of patients with chronic hand dermatitis."

SOURCE: Archives of Dermatology, December 2004.