Novel treatment of chronic severe hand dermatitis with bexarotene gel

• Published in: British journal of dermatology (1951) Vol. 150; no. 3; pp. 545 - 553
• Main Authors: Hanifin, J.M., Stevens, V., Sheth, P., Breneman, D.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.03.2004; Blackwell; Oxford University Press
• Subjects: Administration, Topical; Adult; Aged; Allergic diseases; Anticarcinogenic Agents - administration & dosage; Anticarcinogenic Agents - adverse effects; bexarotene; Biological and medical sciences; Chronic Disease; Dermatologic Agents - administration & dosage; Dermatologic Agents - adverse effects; Dermatology; Dose-Response Relationship, Drug; Eczema - drug therapy; Eczema - pathology; Female; Gels; Hand - pathology; Hand Dermatoses - drug therapy; Hand Dermatoses - pathology; hand eczema; Humans; Immunopathology; irritant contact dermatitis; Male; Medical sciences; Middle Aged; rexinoid; Severity of Illness Index; Skin allergic diseases. Stinging insect allergies; Tetrahydronaphthalenes - administration & dosage; Tetrahydronaphthalenes - adverse effects; Treatment Outcome; Antineoplastic agent; Human; Immunopathology; Allergy; Skin disease; Bexarotene; Dermatology; hand eczema; irritant contact dermatitis; Hand; Local administration; Chemotherapy; Chronic; Hypoglycemic agent; Treatment; Contact dermatitis; Eczema; Severe; rexinoid; Irritation
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1046/j.1365-2133.2003.05729.x

Summary Background  Hand dermatitis is an eczematous inflammation of the hands that is related to occupation or to routine activities. It often becomes chronic, and in some patients may become severe and disabling. Topical corticosteroids are effective treatment, particularly for milder forms, but they often lose effectiveness with time and can produce skin atrophy. Objectives  To evaluate bexarotene gel topical therapy for safety, tolerability and efficacy in patients with chronic hand dermatitis. Methods  A phase I–II open‐label randomized clinical study of bexarotene gel, alone and in combination with a low‐ and a mid‐potency steroid, was conducted in 55 patients with chronic severe hand dermatitis at two academic clinics. Results  Patients using bexarotene gel monotherapy reached a 79% response rate for ≥ 50% clinical improvement and a 39% response rate for ≥ 90% clearance of hands. Adverse events possibly related to treatment in all patients were stinging or burning (15%), flare of dermatitis (16%) and irritation (29%). Thirteen patients (24%) withdrew early, including two for related adverse events and five for inadequate response. Conclusions  Bexarotene gel appears to be safe, tolerated by most patients, with useful therapeutic activity in chronic severe hand dermatitis.