Management of Atopic Hand Dermatitis

Dermatol Clin. 2017 Jul;35(3):365-372. doi: 10.1016/j.det.2017.02.010.

Abstract

This article provides an overview of clinical aspects of hand eczema in patients with atopic dermatitis. Hand eczema can be a part of atopic dermatitis itself or a comorbidity, for example, as irritant or allergic contact dermatitis. When managing hand eczema, it is important to first categorize the subtype and identify potential culprit allergens or irritants. First-line therapy should be a combination of emollients and topical corticosteroids; possible alternatives include topical calcineurin inhibitors or coal tar. Second-line therapy includes UV therapy and systemic therapy, including azathioprine, cyclosporine, methotrexate, and mycophenolate. Prednisolone should only be very infrequently used.

Keywords: Allergic contact dermatitis; Atopic dermatitis; Hand eczema; Irritant contact dermatitis.

Publication types

  • Review

MeSH terms

  • Administration, Cutaneous
  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Calcineurin Inhibitors / therapeutic use
  • Coal Tar / therapeutic use
  • Comorbidity
  • Dermatitis, Atopic / epidemiology*
  • Dermatitis, Atopic / physiopathology
  • Dermatitis, Atopic / therapy*
  • Dermatologic Agents / therapeutic use*
  • Eczema / classification
  • Eczema / epidemiology*
  • Eczema / prevention & control
  • Eczema / therapy*
  • Emollients / therapeutic use
  • Hand Dermatoses / classification
  • Hand Dermatoses / prevention & control
  • Hand Dermatoses / therapy*
  • Humans
  • Skin Physiological Phenomena
  • Ultraviolet Therapy

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Calcineurin Inhibitors
  • Dermatologic Agents
  • Emollients
  • Coal Tar