National Institute for Health and Clinical Excellence (NICE)
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NICE guidance recommends treatment for severe hand eczema

The National Institute for Health and Clinical Excellence (NICE) yesterday (Weds 26 August) published final guidance recommending the use of alitretinoin as a treatment option for adults with severe chronic hand eczema that has not responded to potent topical corticosteroids. In these cases, alitretinoin is recommended, within its licensed indication, if the person is assessed as having severe disease.  Treatment should stop as soon as an adequate response (hands clear or almost clear) has been achieved.  If the eczema is still defined by assessment as severe at 12 weeks, or if an adequate response hasn’t been achieved by 24 weeks, then treatment should also be stopped. 

Professor Peter Littlejohns, Clinical and Public Health Director at NICE said: “Eczema can have a huge impact on an individual, with the condition causing significant discomfort and in severe cases it can be painful.  Scaling, blisters, redness and cracks in the skin are all common symptoms. Severe chronic hand eczema can affect a person’s ability to use their hands, as well as potentially impacting on work and social aspects of their lives.  This new guidance recommending alitretinoin will offer hope to adults whose severe chronic hand eczema hasn’t been helped by strong topical corticosteroids.”

The guidance also recommends that only dermatologists, or physicians with experience in both managing severe chronic hand eczema and the use of systemic retinoids, should start and monitor treatment with alitretinoin. Healthcare professionals should take into account any physical, sensory or learning disabilities, or other communication difficulties that could affect assessment responses.

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