Open-label exploratory study of acitretin for the treatment of severe chronic hand dermatitis

Abstract

Introduction: Acitretin is a retinoid approved for the treatment of psoriasis that has good efficacy for palmoplantar psoriasis. The safety and efficacy of acitretin in severe chronic hand dermatitis (CHD) is unknown.

Methods: A total of nine patients with severe CHD were enrolled and treated with acitretin 10 mg once daily which could be increased to 30 mg daily if well-tolerated. Patients were treated for up to 24 or 12 weeks if the physician global assessment (PGA) was clear or almost clear at that time. CHD severity was evaluated using a 5-grade PGA scale and the modified total lesion symptom score (mTLSS).

Results: The proportion of patients achieving PGA of clear or almost clear was 33.3% (95% CI: 9–69%) and the proportion achieving PGA of clear, almost clear or mild was 44% (95% CI: 15–77%). The mTLSS decreased by 45% (−6.3 ± 4.7; p = 0.02). Three patients did not complete the study: one due to an increase in facial dermatitis, one due to lack of efficacy and one who withdrew consent.

Conclusions: This pilot study suggests that acitretin could improve severe CHD. Further studies are needed to better assess the efficacy and safety of acitretin in patients with severe CHD.

• Alitretinoin and hand eczema
• palmoplantar
• retinoid

Acknowledgements

We thank Philippe Marchessault for his assistance in preparing this article and Miguel Chagnon for his assistance with statistical analysis.

Declaration of interest

This study was funded by Tribute Pharmaceuticals.

J.T. has been an advisor and clinical trial investigator and received honoraria and research grants from Tribute Pharmaceuticals.

C.M. has been a consultant and received honoraria from Actelion.

S.N. has been an investigator and/or consultant and has received honoraria and/or from Tribute Pharmaceuticals, Basilea, Actelion and GSK-Stiefel.

C.B. has been an investigator and/or consultant and has received honoraria from Tribute Pharmaceuticals, Basilea, Actelion and GSK-Stiefel.

B.R. has been an investigator and/or consultant and has received honoraria and/or from Tribute Pharmaceuticals, Basilea, Actelion and GSK-Stiefel.