Detection and treatment of Staphylococcus aureus colonization in chronic hand eczema: a multicenter study

Comparative evaluation of the therapeutic efficacy and the safety of the Tetraderm® cream in comparison with the Triderm® cream in patients with allergic dermatoses, complicated by secondary infection

Often allergic dermatoses complicated by a secondary infection. The main causative agents of pustular skin infections are gram-positive cocci. The goals of external therapy are to eliminate the inflammatory reaction and subjective sensations, eliminate secondary bacterial and fungal infections, reduce dry skin and protect against adverse environmental factors. The effectiveness of local therapy is ensured by properly selected dosage forms of drugs. The aim of this study was to conduct a comparative assessment of the therapeutic efficacy and safety of Tetraderm cream and Triderm cream in patients with inflammatory dermatoses with concomitant bacterial and mycotic infections. The study involved 128 patients, depending on the drug used, the patients were divided into 2 groups. Efficacy was assessed by the relative number of patients (%) with the achieved therapeutic success (by index EASI), the relative number of patients (%) with the achieved therapeutic success on the scale of total clinical judgment of a physician relative number of patients (%) with the achieved improvement in the change in dermatology life quality index DLQI, as well as according to the objective methods of investigation. Safety was evaluated on the basis of monitoring and registration of adverse events, data from clinical laboratory tests. Both drugs demonstrated similar therapeutic efficacy and did not differ in any of the efficacy criteria, both in the ITT population and in the PP population, and also proved to be equally safe.

Handekzem – Gleiche Therapie für alle Formen?

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.

Drugs for the Treatment of Chronic Hand Eczema: Successes and Key Challenges

Chronic hand eczema (CHE) is a common and burdensome inflammatory skin condition seen in up to 10% of the population, more often in high-risk occupational workers. Topical therapeutics comprise the standard of care, but up to 65% of cases do not resolve after treatment, and moderate-to-severe cases are often resistant to topical therapeutics and require systemic options instead. To date, there are no systemic therapeutics approved to treat CHE in the United States, but several drugs are under investigation as potential treatments for CHE. The primary focus of this review is on the novel therapeutics, topical and systemic, that are under investigation in recently completed or currently ongoing trials. This review also briefly outlines the existing treatments utilized for CHE, often with limited success or extensive adverse effects. CHE represents a major challenge for physicians and patients alike, and efforts to improve the minimally invasive diagnostic tools and treatment paradigms are ongoing. In the near future, CHE patients may benefit from new topical and systemic therapeutics that specifically target abnormally expressed immune markers.

Management of chronic hand and foot eczema. An Australia/New Zealand Clinical narrative

Chronic hand/foot eczemas are common, but treatment is often challenging, with widespread dissatisfaction over current available options. Detailed history is important, particularly with regard to potential exposure to irritants and allergens. Patch testing should be regarded as a standard investigation. Individual treatment outcomes and targets, including systemic therapy, should be discussed early with patients, restoring function being the primary goal, with clearing the skin a secondary outcome. Each new treatment, where appropriate, should be considered additive or overlapping to any previous therapy. Management extends beyond mere pharmacological or physical treatment, and requires an encompassing approach including removal or avoidance of causative factors, behavioural changes and social support. To date, there is little evidence to guide sequences or combinations of therapies. Moderately symptomatic patients (e.g. DLQI ≥ 10) should be started on a potent/super-potent topical corticosteroid applied once or twice per day for 4 weeks, with tapering to twice weekly application. If response is inadequate, consider phototherapy, and then a 12-week trial of a retinoid (alitretinoin or acitretin). Second line systemic treatments include methotrexate, ciclosporin and azathioprine. For patients presenting with severe symptomatic disease (DLQI ≥ 15), consider predniso(lo)ne 0.5-1.0 mg/kg/day (or ciclosporin 3 - 5 mg/kg/day) for 4-6 weeks with tapering, and then treating as for moderate disease as above. In non-responders, botulinum toxin and/or iontophoresis, if associated with hyperhidrosis, may sometimes help. Some patients only respond to long-term systemic corticosteroids. The data on sequencing of newer agents, such as dupilumab or JAK inhibitors, are immature.