e1 © 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd. | JDDG | 1610-0379/2014 Guideline DOI: 10.1111/ddg.12510 Guidelines for diagnosis, prevention and treatment of hand eczema Summary The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). In addition to the evidence- and consensus-based recommendation on the treatment of HE, the guidelines cover mainly consensus-based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non-pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long-term treatment beyond six weeks only when necessary and under careful me- dical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed. The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wis- senschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medi- cal Societies in Germany). No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest. Introduction and methodology Scope and purpose Overall objective(s) of the guidelines Eczema is the most common of all inflammatory dermatoses. Eczema compri- ses a group of skin disorders exhibiting a common pattern of histological and clinical findings which vary depending on the stage of the disease. The terms eczema and dermatitis are often thought of as being synonymous. Eczema loca- ted on the hands is one of the most disabling skin conditions in terms of its im- pact on quality of life and occupation. Its treatment can be challenging. Hand eczema (HE) is not a homogeneous disease entity, and is associated with many different etiologies and morphologies. The severity of HE may range from very mild to severe and the course from acute to chronic, resulting in prolonged di- sability. Chronic HE is associated with a high health economic burden and sig- nificant loss of quality of life. Although numerous treatment options are availa- ble, the management of chronic HE is often difficult and unsatisfactory. There Thomas L Diepgen 1 , Klaus E Andersen 2 , Oliver Chosidow 3 , Peter Jan Coenraads 4 , Peter Elsner 5 , John English 6 , Manigé Fartasch 7 , Ana Gimenez-Arnau 8 , Rosemary Nixon 9 , Denis Sasseville 10 , Tove Agner 11 (1) Department of Clinical Social Medicine, Occupational and Environ- mental Medicine, University Hospital Heidelberg, Germany (2) Department of Dermatology, Uni- versity of Southern Denmark, Denmark (3) APHP Hôpitaux Universitaires Henri Mondor, Créteil, France (4) Occupational and Environmental Dermatology Unit, State University Hospital, Groningen, The Netherlands (5) Clinic for Dermatology and Dermatological Allergology, University Hospital Jena, Germany (6) Department of Dermatology, Uni- versity of Nottingham, United Kingdom (7) Department of Clinical and Expe- rimental Occupational Dermatology, Institute for Prevention and Occupatio- nal Medicine, Ruhr University Bochum (IPA), Germany (8) Hospital del Mar, Parc de Salut Mar, Universitat Autonoma Barcelona, Spain (9) Occupational Dermatological Research & Education Center, Victoria, Australia (10) Royal Victoria Hospital, Montreal, Canada (11) University of Copenhagen, Depart- ment of Dermatology D, Bispebjerg Hospital, Copenhagen, Denmark The guidelines are expected to be valid until December 2017 at the latest.
Guidelines for diagnosis, prevention and treatment of hand eczema
May 16, 2023
The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). In addition to the evidence- and consensus-based recommendation on the treatment of HE, the guidelines cover mainly consensus-based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non-pharmacological interventions, topical, physical and systemic treatments.
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Eczema is the most common of all inflammatory dermatoses. Eczema comprises a group of skin disorders exhibiting a common pattern of histological and
clinical findings which vary depending on the stage of the disease. The terms
eczema and dermatitis are often thought of as being synonymous. Eczema located on the hands is one of the most disabling skin conditions in terms of its impact on quality of life and occupation. Its treatment can be challenging. Hand
eczema (HE) is not a homogeneous disease entity, and is associated with many
different etiologies and morphologies.
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