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Photodermatology, Photoimmunology &... Sep 2023
Topics: Humans; Alitretinoin; Retinoids; Tretinoin; Eczema; Photosensitivity Disorders; Chronic Disease
PubMed: 37199021
DOI: 10.1111/phpp.12888 -
The British Journal of Dermatology Dec 2016Chronic hand eczema (CHE) is a common inflammatory skin disease that affects approximately 10% of the population. Systemic alitretinoin has been shown to be effective in...
BACKGROUND
Chronic hand eczema (CHE) is a common inflammatory skin disease that affects approximately 10% of the population. Systemic alitretinoin has been shown to be effective in patients with CHE who are refractory to topical corticosteroids.
OBJECTIVES
To analyse the impact of alitretinoin on the skin barrier genes and protein expression in the skin lesions of patients with CHE.
MATERIALS AND METHODS
Fifteen patients with CHE were treated with 30 mg daily of alitretinoin for up to 27 weeks. Disease severity was assessed using a clinical score. Skin biopsies from all the patients were evaluated before and after therapy for the expression of Ki-67, various skin barrier genes and thymic stromal lymphopoietin (TSLP) by real-time quantitative polymerase chain reaction and immunohistochemistry.
RESULTS
After alitretinoin application, an improvement in the clinical severity of CHE was observed in the majority of patients. Analysis of skin biopsies before treatment showed a significant increase in Ki-67-positive cells in the suprabasal layer and a dysregulated expression of various skin barrier genes, such as claudin 1, loricrin, filaggrin and cytokeratin 10, which were normalized after treatment. TSLP was significantly upregulated in patients with CHE and also normalized after alitretinoin treatment and negatively correlated with filaggrin.
CONCLUSIONS
Our data indicate that the expression of barrier genes and proteins was normalized following treatment with alitretinoin in patients with CHE. The change in expression levels of these genes correlated with the clinical efficacy, suggesting that alitretinoin exhibits a disease-modifying activity. TSLP is upregulated in CHE and seems to counteract filaggrin expression in the skin.
Topics: Administration, Cutaneous; Adult; Aged; Alitretinoin; Chronic Disease; Dermatologic Agents; Drug Administration Schedule; Eczema; Epidermis; Female; Filaggrin Proteins; Gene Expression; Hand Dermatoses; Humans; Ki-67 Antigen; Male; Middle Aged; Tight Junction Proteins; Tretinoin
PubMed: 27480504
DOI: 10.1111/bjd.14921 -
European Journal of Dermatology : EJD 2015Retinoids (vitamin A and its metabolites) are potent natural regulators of cellular activities, including cell growth and differentiation, and they mediate many... (Review)
Review
Retinoids (vitamin A and its metabolites) are potent natural regulators of cellular activities, including cell growth and differentiation, and they mediate many essential regulatory functions, especially in the skin. Biologically active retinoids exert their effects by binding to nuclear retinoic acid receptors and retinoid-X-receptors. The group of pharmacologically used retinoids include naturally occurring and chemically synthesised vitamin A derivatives. Due to their influence on keratinocyte proliferation, epidermal differentiation and keratinisation, retinoids are commonly used in the field of dermatopharmacology. For safe administration of retinoids, in-depth information about adverse effects and comprehensive information of the patient are important. This article gives an overview on the effects, use, and side-effects of topical and systemic retinoids in dermatology.
Topics: Administration, Oral; Administration, Topical; Alitretinoin; Female; Humans; Male; Patient Safety; Retinoids; Skin Diseases; Treatment Outcome; Tretinoin
PubMed: 26069148
DOI: 10.1684/ejd.2015.2544 -
Contact Dermatitis Oct 2022
Randomized Controlled Trial
Efficacy and safety of oral alitretinoin versus oral azathioprine in patients with severe chronic hand eczema: Results from a prematurely discontinued randomized controlled trial.
Topics: Administration, Oral; Alitretinoin; Azathioprine; Chronic Disease; Dermatitis, Allergic Contact; Dermatologic Agents; Eczema; Hand Dermatoses; Humans; Treatment Outcome
PubMed: 35567385
DOI: 10.1111/cod.14161 -
Clinical and Experimental Dermatology Jun 2015
Topics: Alitretinoin; Antineoplastic Agents; Female; Foot Dermatoses; Hand Dermatoses; Humans; Middle Aged; Mycosis Fungoides; Skin Neoplasms; Treatment Outcome; Tretinoin
PubMed: 25476933
DOI: 10.1111/ced.12516 -
Actas Dermo-sifiliograficas Sep 2015Management of hand eczema is complex because of the broad range of different pathogeneses, courses, and prognoses. Furthermore, the efficacy of most available treatments... (Review)
Review
Management of hand eczema is complex because of the broad range of different pathogeneses, courses, and prognoses. Furthermore, the efficacy of most available treatments is not well established and the more severe forms can have a major impact on the patient's quality of life. Patient education, preventive measures, and the use of emollients are the mainstays in the management of hand eczema. High-potency topical corticosteroids are the treatment of choice, with calcineurin inhibitors used for maintenance. Phototherapy or systemic treatments are indicated in patients who do not respond to topical treatments. Switching from topical treatments should not be delayed to avoid sensitizations, time off work, and a negative impact on quality of life. Alitretinoin is the only oral treatment approved for use in chronic hand eczema.
Topics: Adrenal Cortex Hormones; Alitretinoin; Calcineurin Inhibitors; Chronic Disease; Combined Modality Therapy; Dermatitis, Contact; Dermatologic Agents; Disease Management; Eczema; Emollients; Gloves, Protective; Hand Dermatoses; Humans; Immunosuppressive Agents; Occupational Diseases; Phototherapy; Practice Guidelines as Topic; Quality of Life; Tretinoin
PubMed: 26005193
DOI: 10.1016/j.ad.2015.04.005 -
Journal of the American Academy of... Dec 2002
Topics: Administration, Topical; Adult; Aged; Alitretinoin; Drug Administration Schedule; Female; Follow-Up Studies; Gels; Granuloma, Pyogenic; Hand Dermatoses; Humans; Treatment Outcome; Tretinoin
PubMed: 12451394
DOI: 10.1067/mjd.2002.121346 -
La Clinica Terapeutica 2013Alitretinoin is a unique retinoid authorised for the treatment of adults with severe chronic hand eczema (CHE) refractory to potent topical steroids. The most common...
Alitretinoin is a unique retinoid authorised for the treatment of adults with severe chronic hand eczema (CHE) refractory to potent topical steroids. The most common adverse events (AEs) were typical class effects of oral retinoids including headache, flushing and skin disorders. To our knowledge, there are no cases of sensitization to alitretinoin reported in literature. We present a case of sensitization to alitretinoin.
Topics: Adult; Alitretinoin; Drug Eruptions; Female; Hand Dermatoses; Humans; Tretinoin
PubMed: 23868640
DOI: 10.7417/CT.2013.1570 -
The Journal of Dermatological Treatment Nov 2016Severe chronic hand eczema (CHE) has a debilitating effect on quality of life (QoL). PASSION evaluated the effectiveness of oral alitretinoin on QoL and work... (Observational Study)
Observational Study
PURPOSE
Severe chronic hand eczema (CHE) has a debilitating effect on quality of life (QoL). PASSION evaluated the effectiveness of oral alitretinoin on QoL and work productivity in patients with severe CHE following prescribing guidelines.
METHODS
A non-interventional, open-label, observational, multicentre study conducted in Germany in fulfilment of German guidelines. Patients (n = 631) were treated with once-daily alitretinoin for ≤24 weeks under standard daily practise conditions. Effectiveness was assessed by Physician Global Assessment (PGA), QoL Assessment (EQ-5D) and work impairment. Tolerability and safety were assessed by adverse event (AE) monitoring.
RESULTS
In total, 279 (44.2%) patients dropped out before Week 24. Of the 631 patients enrolled, 29.8% achieved a PGA rating of clear/almost clear at Week 24. Mean (standard deviation) EQ-5D utility and EQ-5D visual analogue scale scores at baseline were 0.76 (0.25) and 53.6 (23.55), respectively, and increased to 0.94 (0.12) and 80.8 (19.23) at Week 24, indicating improved QoL. At baseline, 49.4%/29.1% of patients reported strong/very strong workplace impairment, respectively, and decreased to 8.5%/1.4%, respectively, at Week 24. AEs were reported in 116 (18.4%) patients. No new safety signals were observed.
CONCLUSIONS
Alitretinoin produced marked improvement in the QoL and work productivity of patients with severe CHE.
Topics: Alitretinoin; Antineoplastic Agents; Chronic Disease; Dermatologic Agents; Eczema; Female; Hand Dermatoses; Humans; Male; Middle Aged; Quality of Life; Tretinoin
PubMed: 27618281
DOI: 10.1080/09546634.2016.1227422 -
Actas Dermo-sifiliograficas Mar 2016Hand eczema affects nearly 10% of the population. The condition becomes severe and chronic in 5% to 7% of cases and is refractory to topical corticosteroids in 2% to 4%.... (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVE
Hand eczema affects nearly 10% of the population. The condition becomes severe and chronic in 5% to 7% of cases and is refractory to topical corticosteroids in 2% to 4%. This study aimed to describe the current use of oral alitretinoin in treating Spanish national health system patients with hand eczema that is refractory to potent topical corticosteroids.
MATERIALS AND METHODS
Observational, descriptive, exploratory, cross-sectional study based on the retrospective analysis of records for patients with hand eczema treated with alitretinoin in the Spanish national health system.
RESULTS
We reviewed the records for 62 patients in 13 hospitals in 5 different administrative areas (autonomous communities) of Spain. Alitretinoin was usually used at a dosage of 30mg/d. In most cases the physician judged the clinical response to be satisfactory after a single cycle. The recorded adverse effects were foreseeable and of the type reported for systemic retinoids. The dermatologists agreed that the clinical benefits achieved with alitretinoin favored adherence to treatment and an early return to work.
CONCLUSIONS
The results show that oral alitretinoin is being used according to established recommendations and that response is good, with few adverse effects. The dermatologists agreed that the benefits favored adherence and improved the patients' health related quality of life.
Topics: Alitretinoin; Chronic Disease; Cross-Sectional Studies; Eczema; Hand Dermatoses; Humans; Retrospective Studies; Spain; Tretinoin
PubMed: 26363930
DOI: 10.1016/j.ad.2015.08.002