4136 Efficacy and Safety of Oral Acitretin in Chronic Hand Eczema

Saturday, 17 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Hyun-Ju Jin, MD , Department of Dermatology, Pusan National University, Pusan, South Korea

Jin-Hwa Son, MD , Department of Dermatology, Pusan National University, Pusan, South Korea

Jeong-Min Kim, MD , Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, South Korea

Gun-Wook Kim, MD , Department of Dermatology, Pusan National University, Pusan, South Korea

Je-Ho Mun, MD , Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, South Korea

Margaret Song, MD , Department of Dermatology, Pusan National University, Pusan, South Korea

Hoon-Soo Kim, MD , Department of Dermatology, Pusan National University, Pusan, South Korea

Hyun-Chang Ko, MD , Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, South Korea

Moon-Bum Kim, MD, PhD , Department of Dermatology, Pusan National University, Pusan, South Korea

Byung Soo Kim, MD, PhD , Department of Dermatology, Pusan National University, Pusan, South Korea

A) Background : Chronic hand eczema (CHE) may severely reduce patient's quality of life.  CHE refractory to topical corticosteroids currently have limited treatment options suited for chronic use.  In demand of safe new therapy, oral alitretinoin, 9-cisretinoic acid, was proposed, but the economic burden limits its broad use.  Acitretin is a well-known second generation vitamin A derivative, widely used in palmoplantar psoriasis with less cost. The investigation was performed to assess the efficacy and safety of acitretin in chronic hand eczema patients

B) Methods : Total of 25 patients diagnosed with CHE were enrolled in the prospective open-label study.  All patients were administered with oral acitretin, start dose of 10mg twice daily and tapered to 10mg once daily, during 8 week period.  CHE severity was evaluated using a hand eczema severity index and 5-grade physicial global assessment (PGA)

C) Results : Severity of hand eczema decreased by 58% in average. The improvement was more remarkable in hyperkeratotic type than other types of hand eczema (p<0.004). Clinical responses, defined as clear or almost clear, were achieved in up to 36% of patients. No serious side effects were reported except of mild cheilitis in 2 patients and abdominal discomfort in 1 patients.

D) Conclusion : Oral acitretin is well-tolerated with effectively improving chronic hand eczema, especially in hyperkeratotic type.