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Aktuelle Dermatologie 2021; 47(06): 253-258
DOI: 10.1055/a-1337-0416
Übersicht

Handekzem – Gleiche Therapie für alle Formen?[*]

Hand Dermatitis – One fits all?
C. Bayerl
Klinik für Dermatologie und Allergologie, Hauttumorzentrum Wiesbaden, Helios Dr. Horst Schmidt Kliniken, Wiesbaden
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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.




Publikationsverlauf

Artikel online veröffentlicht:
14. April 2021

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  • 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
    CrossrefPubMedGoogle Scholar
  • 2 Elsner P, Agner T. Hand eczema: treatment. JEADV 2020; 34 (Suppl. 01) 13-21
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 4 Diepgen TL, Scheidt R, Weisshaar E. et al. Cost of illness from occupational hand eczema in Germany. Contact Dermatitis 2013; 69: 99-106
    CrossrefPubMedGoogle Scholar
  • 5 Raman M, Krishna SG. A novel cause of economic loss due to hand dermatitis. Arch Dermatol 2011; 147: 753
    CrossrefPubMedGoogle Scholar
  • 6 Hankinson A, Lloyd B, Alweis R. Lime-induced phytophotodermatits. J Comm Hosp Intern Med Persp 2014; 29: 4 PMID: 25317269
    PubMedGoogle Scholar
  • 7 Mahler V, Glöckler A, Worm M. et al. Proteinkontaktdermatitis. Allergologie 2013; 36: 219-226
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 9 Agner T, Elsner P. Hand eczema: epidemiology, prognosis and prevention. JEADV 2020; 34 (Suppl. 01) 4-12
    PubMedGoogle Scholar
  • 10 Politiek K, Loman L, Pas HH. et al. Hyperkeratotic hand eczema: eczema or not?. Contact Dermatitis 2020; 83: 196-205
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 12 Lee GF, Maarouf M, Hendricks AK. et al. Current and emerging therapy for hand eczema. Dermatologic Therapy 2019; 32: e12840
    PubMedGoogle Scholar
  • 13 Garzorz-Stark N, Eyerich K. Molecular diagnostics of hand eczema. Hautarzt 2019; 70: 760-765
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 15 Thyssen JP, Silverberg JI, Guttman-Yassky E. Chronic hand eczema understanding has ramifications on clinical management. JEADV 2020; 34: e429-e430
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 18 Brans R, Skudlik C. Prevention of hand eczema. Hautarzt 2019; 70: 797-803
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 20 Mahler V, Dickel H. Most important contact allergens in hand eczema. Hautarzt 2019; 70: 778-789
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 23 Luger T, Loske KD, Elsner P. et al. Topical skin therapy with glucocorticoids – therapeutic index. JDDG 2004; 2: 629-634
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 26 Christoffers WA, Coenraads PJ, Svensson A. et al. Interventions for hand eczema. Cochr Database System Rev 2019; 26: 4 PMID: 31025714
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 28 Dhillon S. Delgocitinib: First approval. Drugs 2020; 80: 609-615
    CrossrefPubMedGoogle Scholar
  • 29 Juntongjin P, Pongpraesert R. Calcipotriol ointment shows comparable efficacy to topical steroid s in chronic hand eczema. Derm Therapy 2019; 32: e12956
    CrossrefPubMedGoogle Scholar
  • 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
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 34 Nada HR, Rashed LA, Elantaby DMM. et al. Expression of retinoid receptors in hand eczema. Int J Dermatol 2020; 59: 576-581
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 37 Scheerer C, Eyerich K. Pathogenese des atopischen Ekzems. Hautarzt 2018; 69: 191-196
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar