Subscribe to RSS
DOI: 10.1055/a-1337-0416
Handekzem – Gleiche Therapie für alle Formen?[*]
Hand Dermatitis – One fits all?Zusammenfassung
Es gibt nicht einen einzigen Typ des chronischen Handekzems (CHE) – weder morphologisch noch immunologisch. Schutz und Präventionsmaßnahmen können für alle Typen des CHE definiert werden. Die Therapie muss passen und zielgerichtet sein. Einige Therapien können jedoch für alle Typen des Handekzems angeboten werden wie topische Kortikosteroide, Calcineurinantagonisten, UV-Therapie und Alitretinoin, ggf. auch Dupilumab, was in größeren Studien untersucht werden sollte. Die Wahrnehmung des Handekzems sollte gerade in Zeiten der Irritation durch Desinfektion der Hände erhöht werden, damit Prävention und frühzeitige Therapie erfolgen können.
Abstract
There is not just one type of chronic hand dermatitis (CHD) – neither morphologically nor immunologically. Protective measures must be used for all types of CHD. Therapies have to aim for the individual type of dermatitis. Nevertheless, some therapies are generally used for CHD like topical corticosteroids, calcineurin inhibitors, ultraviolet therapies and alitretinoin, probably dupilumab as well. The latter should be studied in clinical controlled trials for CHD. Awareness of CHD should be increased especially in times of irritation of the hands by desinfection. Prevention and early therapy are mandatory.
* Vortrag anlässlich der Korting-Gedächtnisvorlesung, 6. November 2020 beim digitalen Symposium anlässlich des 25-jährigen Bestehens der GD, Gesellschaft für Dermopharmazie e. V.
Publication History
Article published online:
14 April 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Thyssen JP, Johansen JD, Linneberg A. et al. The epidemiology of hand eczema in the general population – prevalence and main findings. Contact Dermatitis 2010; 62: 75-87
- 2 Elsner P, Agner T. Hand eczema: treatment. JEADV 2020; 34 (Suppl. 01) 13-21
- 3 Cazzaniga S, Apfelbacher C, Diepgen T. et al. Patterns of chronic hand eczema: a semantic map analysis of the CARPE registry data. Br J Dermatol 2018; 178: 229-237
- 4 Diepgen TL, Scheidt R, Weisshaar E. et al. Cost of illness from occupational hand eczema in Germany. Contact Dermatitis 2013; 69: 99-106
- 5 Raman M, Krishna SG. A novel cause of economic loss due to hand dermatitis. Arch Dermatol 2011; 147: 753
- 6 Hankinson A, Lloyd B, Alweis R. Lime-induced phytophotodermatits. J Comm Hosp Intern Med Persp 2014; 29: 4 PMID: 25317269
- 7 Mahler V, Glöckler A, Worm M. et al. Proteinkontaktdermatitis. Allergologie 2013; 36: 219-226
- 8 Bauer A, Schubert S, Geier J. et al. Type IV contact allergies in the food processing industry: an update. Hautarzt 2018; 69: 443-448
- 9 Agner T, Elsner P. Hand eczema: epidemiology, prognosis and prevention. JEADV 2020; 34 (Suppl. 01) 4-12
- 10 Politiek K, Loman L, Pas HH. et al. Hyperkeratotic hand eczema: eczema or not?. Contact Dermatitis 2020; 83: 196-205
- 11 Tauber M, Bérard E, Lourari S. et al. Latent class analysis categorizes chronic hand eczema patients according to skin barrier impairment. JEADV 2020; 34: 1529-1535
- 12 Lee GF, Maarouf M, Hendricks AK. et al. Current and emerging therapy for hand eczema. Dermatologic Therapy 2019; 32: e12840
- 13 Garzorz-Stark N, Eyerich K. Molecular diagnostics of hand eczema. Hautarzt 2019; 70: 760-765
- 14 Diepgen TL, Andersen KE, Chosidow O. et al. Guidelines for diagnosis and treatment of hand eczema – short version. JDDG 2015; 13: 77-84 DOI: 10.1111/ddg.12510.
- 15 Thyssen JP, Silverberg JI, Guttman-Yassky E. Chronic hand eczema understanding has ramifications on clinical management. JEADV 2020; 34: e429-e430
- 16 Silverberg JI, Guttman-Yassky E, Agner T. et al. Chonic hand eczema guidelines from an expert panel of the international eczema council. Dermatitis 2020
- 17 Erdil D, Koku Aksu AE, Gür TF. et al. Hand eczema treatement: Change behaviour with text messaging, a randomized trial. Contact Dermatitis 2020; 82: 153-160
- 18 Brans R, Skudlik C. Prevention of hand eczema. Hautarzt 2019; 70: 797-803
- 19 Tauber M, Lourari S, Bérard E. et al. Positive change in hand care habits using therapeutic patient education in chronic hand eczema. Contact Dermatitis 2020; 82: 10-17
- 20 Mahler V, Dickel H. Most important contact allergens in hand eczema. Hautarzt 2019; 70: 778-789
- 21 Schmidt-Wendtner MH, Korting HC. The pH of the skin surface and its impact on the barrier function. Skin Pharmacol Physiol 2006; 19: 296-302
- 22 Schackert C, Korting HC, Schäfer-Korting M. Qualitative and quantitative assesssment of the benefit-risk ratio of medium potency topical corticosteroids in vitro and in vivo. BioDrugs 2000; 13: 267-277
- 23 Luger T, Loske KD, Elsner P. et al. Topical skin therapy with glucocorticoids – therapeutic index. JDDG 2004; 2: 629-634
- 24 Chen Y, Wang X, Zhang C. et al. Detection and treatment of staphylococcus aureus colonization in chronic hand eczema: a multicenter study. J Dermatol Treatment 2019; 30: 565-567
- 25 Wang X, Xu W, Chen Y. et al. Staphylococcus aureus colonization and chronic hand eczema: a multicenter clinical trial. Arch Dermatol Res 2019; 311: 513-518
- 26 Christoffers WA, Coenraads PJ, Svensson A. et al. Interventions for hand eczema. Cochr Database System Rev 2019; 26: 4 PMID: 31025714
- 27 Worm M, Bauer A, Elsner P. et al. Efficacy and safety of topical delgocitinib in patients with chronic hand eczema: data from a randomized, double-blind, vehicle-controlled phase IIa study. Br J Dermatol 2020; 182: 1103-1110
- 28 Dhillon S. Delgocitinib: First approval. Drugs 2020; 80: 609-615
- 29 Juntongjin P, Pongpraesert R. Calcipotriol ointment shows comparable efficacy to topical steroid s in chronic hand eczema. Derm Therapy 2019; 32: e12956
- 30 Adam S, Bayerl C. Mittel-Dosis-UVA-1- und lokale PUVA-Therapie beim dyshidrosiformen Handekzem – eine prospektive randomisierte Studie. Akt Dermatol 2007; 33: 142-145
- 31 Bayerl C, Garbea A, Frosch PJ. et al. Pilotstudie zur Therapie des beruflich bedingten Handekzems mit einer neuen tragbaren UVB-Bestrahlungseinheit. Akt Derm 1999; 25: 302-305
- 32 Ruzicka T, Lynde CW, Jemec GB. et al. Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids; results of a randomized, double-blind, placebo-controlled, multicentre trial. Br J Dermatol 2008; 158: 808-817
- 33 Diepgen T, Pfarr E, Zimmermann T. Efficacy and tolerability of alitretinoin for chonic hand eczema under daily practice conditions: results of the TOCCATA open study comprising 689 patients. Acta Derm Venereol 2012; 92: 251-255
- 34 Nada HR, Rashed LA, Elantaby DMM. et al. Expression of retinoid receptors in hand eczema. Int J Dermatol 2020; 59: 576-581
- 35 Luchsinger I, Vogler T, Schwieger-Briel A. et al. Safe and effective use of alitretinoin in children with recalcitrant hand eczema and other dermatoses – a retrospective analysis. Eur J Acad Dermatol Venereol 2020; 3: 1037-1042
- 36 Werfel T, Allam JP, Biedermann T. et al. Cellular and molecular immunologic mechanisms in patients with atopic dermatitis. J Allergy Clin Immunol 2016; 138: 336-349
- 37 Scheerer C, Eyerich K. Pathogenese des atopischen Ekzems. Hautarzt 2018; 69: 191-196
- 38 Oosterhaven JAF, Voorberg AN, Romeijn GLE. et al. Effect of dupilumab in hand eczema in patients with atopic dermatitis: an observational study. J Dermatol 2019; 46: 680-685
- 39 Lohmann L, Diercks GFH, Schuttelaar MLA. Three cases if non-atopic hyperkeratotic hand eczema treated with dupilumab. Contact Dermatitis 2020; DOI: 10.1111/cod.13693. PMID: 32864776
- 40 Halling A-S, Zachariae C, Thyssen JP. Severe treatment-resistant acute und recurrent vesicular chronic hand eczema successfully treated with dupilumab. Contact Dermatitis 2020; 83: 37-38
- 41 Pradhan S, Kroumpouzos G, Goldust M. Hand eczema due to frequent hand washing in combat with COVID-19. J Cosmetic Dermatol 2020; 19: 2472-2475
- 42 Sollena P, Capilli S, Piccerillo A. et al. COVID-19 hygiene measures: hand eczema and insights into ACE2 and integrins as key molecules ofr SARS-CoV-2 cutaneous transmission. Int J Dermatol 2020; DOI: 10.1111/ijd.15208.
- 43 Lan J, Song Z, Miao C. et al. Skin damage among health care workers managing coronavuirus disease – 2019. J Am Acad Dermatol 2020; 82: 1215-1216
- 44 Guertler A, Moellhoff N, Schenck T. et al. Onset of occupational hand eczema among healthcare workers during SARS-CoV-2 pandemic: comparing a single surgical site with a COVID-19 intensive care unit. Contact Dermatitis 2020; 83: 108-114