Alitretinoin, an orally administered retinoid, is recommended for adults whose disease has not responded to potent topical corticosteroids. Eligible patients must also have a dermatology life quality index (DLQI) score of 15 or more.
Treatment with alitretinoin should be stopped:
- when an adequate response (hands clear or almost clear) is achieved.
- if eczema remains severe after 12 weeks.
- if an adequate response is not achieved by 24 weeks.
Disease is considered ‘severe' if defined as such by the physician's global assessment (PGA).
Only physicians who are experienced in both the management of severe chronic hand eczema and the use of systemic retinoids should start and monitor treatment with alitretinoin.