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Ferrucci S, Persichini P, Gola M, Scandagli I, Pigatto P, Legori A, Musumeci ML, Micali G, D'Agata E, Schena D, Azzolini A, Gallo R, Trave I, Cristaudo A, Patruno C, Napolitano M, Zucca M, Piras V, Stingeni L, Bianchi L, Corazza M, Zedde P, Foti C, Romita P, Cannavò SP, Guarneri F. DECISA Project (DErmatology Clinics in Italy: Survey on Alitretinoin): A real-life retrospective cohort multicenter study on 438 subjects with chronic hand eczema. Dermatol Ther 2021; 34:e14911. [PMID: 33619833 DOI: 10.1111/dth.14911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/06/2021] [Accepted: 02/13/2021] [Indexed: 10/22/2022]
Abstract
Alitretinoin is the only systemic agent approved to treat moderate-severe chronic hand eczema (CHE) unresponsive to potent topical corticosteroids. No nationwide Italian data regarding real-life efficacy, safety, and tolerability of treatment are available. The DECISA project (DErmatology Clinics in Italy: Survey on Alitretinoin) retrospectively examined data from a registry including 15 Dermatology Clinics authorized to prescription of alitretinoin for CHE patients. Disease severity was assessed at baseline, and after 3 and 6 months of treatment, using the 5-point Physician Global Assessment (PGA) and the modified Total Lesion-Symptoms-Severity (mTLSS) scores. Between November 2010 and July 2018, data of 248 male and 190 female patients (mean age 49.71 ± 13.20 years) treated with alitretinoin were collected. Of them, 43.2% had irritant contact dermatitis, 22.2% allergic contact dermatitis, 18.0% atopic dermatitis, 16.7% mixed (irritant/allergic) type of eczema. At 3 months, the 420 re-evaluated patients showed significantly reduced mTLSS and PGA (P < .0000001 vs baseline for both); PGA was clear/almost clear in 35.6% of cases. At 6 months, the 341 re-evaluated patients showed significant (P < .0000001) improvement of mTLSS and PGA vs baseline and 3 months (PGA clear/almost clear: 41.4%). Relapses occurred in 125 patients; 58 underwent an additional course of alitretinoin, with similarly good results. No relevant safety issues were reported; 86 patients experienced adverse effects, which forced 40 to prematurely stop treatment. The DECISA project results confirm the real-life efficacy, safety and tolerability of alitretinoin in the treatment of moderate to severe CHE refractory to standard topical therapies.
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Affiliation(s)
- Silvia Ferrucci
- U.O.C. Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Paola Persichini
- U.O.C. Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Massimo Gola
- SAS di Dermatologia Allergologica e Professionale-AUSL Toscana Centro e Università degli Studi di Firenze, Florence, Italy
| | - Ilaria Scandagli
- SAS di Dermatologia Allergologica e Professionale-AUSL Toscana Centro e Università degli Studi di Firenze, Florence, Italy
| | - Paolo Pigatto
- UO Dermatologia IRCCS Ospedale Galeazzi & Università degli Studi di Milano, Milan, Italy
| | - Agostina Legori
- UO Dermatologia IRCCS Ospedale Galeazzi & Università degli Studi di Milano, Milan, Italy
| | - Maria Letizia Musumeci
- Dermatology Clinic, University of Catania, PO G. Rodolico, AOU Policlinico-Vittorio Emanuele, Catania, Italy
| | - Giuseppe Micali
- Dermatology Clinic, University of Catania, PO G. Rodolico, AOU Policlinico-Vittorio Emanuele, Catania, Italy
| | - Elisabetta D'Agata
- Dermatology Clinic, University of Catania, PO G. Rodolico, AOU Policlinico-Vittorio Emanuele, Catania, Italy
| | - Donatella Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Alan Azzolini
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Rosella Gallo
- Clinica Dermatologica-DISSAL, Università di Genova e Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Ilaria Trave
- Clinica Dermatologica-DISSAL, Università di Genova e Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Antonio Cristaudo
- UOSD Dermatologia MST, Ambientale, Tropicale e Immigrazione Istituto Dermatologico San Gallicano (IRCCS), Rome, Italy
| | - Cataldo Patruno
- Unit of Dermatology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Maddalena Napolitano
- Department of Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Myriam Zucca
- Dermatologic Clinic, Hospital S. Giovanni di Dio, Cagliari, Italy
| | - Viviana Piras
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Medicine, University of Perugia, Italy
| | - Leonardo Bianchi
- Dermatology Section, Department of Medicine, University of Perugia, Italy
| | - Monica Corazza
- Sezione di Dermatologia, Dipartimento di Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - Pierantonia Zedde
- Sezione di Dermatologia, Dipartimento di Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - Caterina Foti
- Dipartimento di Scienze Biomediche ed Oncologia Umana, Clinica Dermatologica, Bari, Italy
| | - Paolo Romita
- Dipartimento di Scienze Biomediche ed Oncologia Umana, Clinica Dermatologica, Bari, Italy
| | | | - Fabrizio Guarneri
- Dipartimento di Medicina Clinica e Sperimentale-Dermatologia, Università di Messina, Messina, Italy
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Sobering G, Dika C. Vesicular hand dermatitis. Nurse Pract 2018; 43:33-37. [PMID: 30289789 DOI: 10.1097/01.npr.0000546445.09474.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Vesicular hand dermatitis is a type of eczema involving the fingers, hands, and sometimes the feet. It is common in primary care, requiring prompt treatment to prevent chronicity. The cause is often unknown, making the condition challenging to treat. Management consists of avoiding irritants and using emollients and topical corticosteroids.
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Affiliation(s)
- Geraldine Sobering
- Geraldine Sobering is an NP at Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada. Cheryl Dika is the director of the Nurse Practitioner program at the College of Nursing Rady Faculty of Health Sciences, Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, Manitoba, Canada
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