Managing Atopic Dermatitis and chronic Hand Eczema: The Challenge at Hand: Sponsored by Leo-Managing Atopic Dermatitis and Chronic Hand Eczema: The Challenge at Hand

Video Transcription

Video Summary

The transcript is a dermatology educational session featuring Dr. Bob Gang and Dr. Jonathan Silverberg on chronic hand eczema (CHE) and atopic dermatitis (AD). The speakers emphasize that CHE is a distinct, multifactorial disease, not simply a subtype of AD. It can be chronic or relapsing, may present with itch, pain, fissures, vesicles, scaling, and nail changes, and significantly affects quality of life, work, and daily functioning.<br /><br />A major theme is the overlap between CHE and AD: some patients have CHE alone, some have AD with hand involvement, and others may have both AD and superimposed irritant or allergic contact dermatitis. The presenters stress that morphology alone cannot reliably determine etiology, so clinicians should keep a broad differential and consider patch testing, especially in persistent or occupational cases.<br /><br />Treatment discussion covers the limits of topical corticosteroids, especially with repeated use on the hands, where skin atrophy and barrier damage are common. They review the evolving treatment landscape, including topical pan-JAK inhibitors and IL-4/IL-13 biologic therapy, and note that symptom relief can begin within days even if full lesion clearance takes longer. They also explain CHE trial outcome measures such as IGA-CHE, HEX-E, and symptom scales.<br /><br />The session closes with case-based teaching points: a construction worker with CHE alone, an artist with AD and hand involvement, and a more complex patient whose hands remain active despite systemic therapy. The key takeaway is that “hope is at hand” because newer, more targeted therapies and better diagnostic strategies are improving management.

Keywords

chronic hand eczema

atopic dermatitis

hand eczema

contact dermatitis

patch testing

topical corticosteroids

JAK inhibitors

IL-4/IL-13 biologic therapy

quality of life

occupational dermatitis