Effective Long-Term Management Is an Unmet Need for Patients with Chronic Hand Eczema

The toolbox for the treatment of chronic hand eczema (CHE) has continued to expand, with targeted therapies setting new standards for disease control. Nevertheless, findings from a survey of healthcare providers, presented at the 2025 Fall Clinical Conference in Las Vegas, revealed that many patients with moderate-to-severe CHE continue to struggle with inadequate management of their disease. 

CHE is a common and challenging inflammatory skin disease characterized by persistent hand dermatitis that lasts over 3 months or recurs at least twice a year. Studies have shown that the impact of CHE reaches far beyond the surface of the skin, affecting quality of life for many patients. A large portion of individuals living with CHE have reported that their symptoms take a significant toll on their mental health and can often impair productivity (Cortesi PA et al. Contact Dermatitis 2014; 70:158-68). Despite the significant impact of CHE on physical and mental health, many healthcare providers remain unfamiliar with the heterogeneous presentation of CHE and are unsure about the best strategies for its management. 

Raj Chovatiya, MD, PhD, an assistant professor of dermatology at Northwestern University Feinberg School of Medicine in Chicago, and colleagues analyzed data collected from 192 healthcare providers across the United States, including dermatologists, nurse practitioners, and physician assistants, to examine their familiarity with the impact of CHE on patients’ lives, as well as their use of different therapies. The information was collected using a 15-minute online survey administered between January 10 and February 4, 2025.

Overall, the responses reflected providers’ dissatisfaction with the treatment options that are currently available for CHE. More than half of the practitioners said that treating CHE was more challenging than managing other conditions, such as psoriasis. Providers estimated that 37% of patients had at least one office visit related to the inefficacy of treatment in the past 6 months. Patients with moderate to severe CHE also had a high utilization of healthcare resources, typically logging four to five annual visits with a provider and using three medications over the course of treatment, on average. 

Although providers were generally familiar with off-label therapies that have been used in the treatment of moderate-to-severe CHE, including biologic therapies and Janus kinase inhibitors, more than half of responders stressed that there is an unmet need for therapies targeting the underlying mechanisms of CHE. 

Most practitioners said they were aware of the significant effects of moderate-to-severe CHE on patients’ sleep, ability to perform work, social interactions, and overall quality of life. “Despite healthcare providers’ awareness of the impact of CHE, treatment effectiveness remains a challenge,” the authors concluded. “There is a need for new treatments specifically targeting CHE.”