Hyperkeratotic eczema is a condition which happens on the hands and/or feet palm. It is a well-known yet a complicated entity that is usually chronic and difficult to be cured by therapy. The visible signs are represented by dry, thick, gray plaques implicating the palmar and/or plantar surfaces.
Treatment of hyperkeratotic eczema is often difficult or challenging. The cause of hyperkeratotic eczema is not easily understood in most cases; it has been debated if it is actually a variant of hand-foot psoriasis or not.
It is claimed that from a clinical perspective, occasionally it is difficult to differentiate “chronic hand eczema” from “chronic hand psoriasis”. But, when classic features of psoriasis are visible and/or psoriatic lesions involve other cutaneous sites, distinction between both disorders become much more tangible.
It has been acknowledged that chronic hyperkeratotic (hyperkeratosis) eczema is more about “clinical merging of a collection of heterogeneous diseases” that develops periodically, with dry, skin changes representing the final common of the reaction pattern. The main thing, it affects palmar and/or plantar skin becomes exceedingly hyperkeratotic and fissured.
Although the cause and the exact diagnosis often cannot be discovered, the sufferers still need help. Due to a probability for relapse, exacerbations, chronicity and mutable reaction to therapy, finding an effective treatment regimen often constitutes a big challenge.
Treatment of chronic hyperkeratotic eczema may involve use of several paces. Topical corticosteroids, topical calcineurin inhibitors, “keratolytic” paces, emollients and hand protectants are frequently used; combination topical therapy is often employed.
Chronic Hyperkeratotic hand and foot Eczema treatment and acitretin’s role
Acitretin is an oral retinoid agent which shows a much shorter half-life than its parent compound. Systemic retinoid therapy has been claimed as “the most effective treatment choice” for hyperkeratotic eczema of the hands and feet, although scientific data has been limited.
Although the regimen of acitretin in the management of chronic hyperkeratotic hand and foot eczema is not famous, some anti-inflammatory effects of retinoids have been recognized. Systemic retinoids such as acitretin may generate alterations in serum lipids. They are teratogenic and sometimes associated with necessary increases in hepatic enzymes. Moreover, they may produce skeletal and ligamentous calcification after prolonged use.
The use of acitretin in low-dose has been confirmed to be an effective and safe treatment for chronic hyperkeratotic eczema of hands and feet. Current data of clinical and observational experience sustain the efficacy and safety of this approach.