Wollina Uwe
Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital, Technical Unicersity of Dresden, Friedrichstrasse 41, 01067 Dresden, Germany.
Expert Opin Investig Drugs. 2008 Jun;17(6):897-904. doi: 10.1517/13543784.17.6.897.
Pompholyx is a chronic relapsing inflammatory vesicobullous skin disease of the hands and feet belonging to the spectrum of eczema. Established treatments, both topical and systemic, are limited in efficacy, risk:benefit ratio and prevention of further relapses. New treatment options are needed.
The article will discuss new treatment options, in particular for cheiropompholyx.
A MEDLINE and ClinicalTrials.gov research has been conducted and publications about new and emerging treatments for pompholyx have been analysed.
RESULTS/CONCLUSIONS: Among the recent developments, topical calcineurin inhibitors (TCI) and botulinum toxin A (BTXA) seem to be effective against pompholyx. The major disadvantage of BTXA is the need for injections, but efforts are being made to develop a topical form of application. Bexaroten gel has been used for chronic hand dermatitis, with good efficacy in the hyperkeratotic type. Further studies on pompholyx are needed. There is currently widespread interest in plant-based pharmaceuticals. Studies involving such topical drugs are on the way. In systemic treatment, retinoid alitretinoin has been most extensively studied in hand dermatitis. However, experiences relating to pompholyx are more limited. New types of anti-inflammatory oral drugs such as leukotriene inhibitors and phosphodiesterase-4 (PDE4) inhibitors have become available. These seem to have potential in the adjuvant treatment of pompholyx. Monoclonal antibodies of various types have been investigated in small series, but have failed to demonstrate consistent efficacy. Further investigations with new monoclonals are needed. Phototherapy of pompholyx is a cornerstone in treatment. High-dose UVA1 has been established as an effective modality in centres where the rather expensive equipment is available. Recently, UV-free phototherapy has been introduced, but more data are needed before final conclusions can be drawn.
汗疱疹是一种慢性复发性炎症性手足水疱大疱性皮肤病，属于湿疹范畴。现有的局部和全身治疗方法在疗效、风险效益比以及预防进一步复发方面都存在局限性。因此需要新的治疗选择。
本文将讨论新的治疗选择，尤其是针对手部汗疱疹的治疗方法。
检索了MEDLINE和ClinicalTrials.gov数据库，并分析了有关汗疱疹新出现治疗方法的文献。
结果/结论：在最近的研究进展中，局部钙调神经磷酸酶抑制剂（TCI）和肉毒杆菌毒素A（BTXA）似乎对汗疱疹有效。BTXA的主要缺点是需要注射，但目前正在努力开发局部应用剂型。贝沙罗汀凝胶已用于慢性手部皮炎，对角化过度型有良好疗效。需要对汗疱疹进行进一步研究。目前人们对植物源药物广泛关注。涉及此类局部药物的研究正在进行中。在全身治疗方面，维甲酸类药物阿利维A酸在手部皮炎方面研究最为广泛。然而，关于汗疱疹的经验较为有限。新型抗炎口服药物如白三烯抑制剂和磷酸二酯酶-4（PDE4）抑制剂已可供使用。这些药物似乎在汗疱疹的辅助治疗中有潜力。各类单克隆抗体已在小样本研究中进行了调查，但未能证明其疗效一致。需要对新的单克隆抗体进行进一步研究。汗疱疹的光疗是治疗的基石。高剂量UVA1在有昂贵设备的中心已被确立为一种有效的治疗方式。最近，无紫外线光疗已被引入，但在得出最终结论之前还需要更多数据。
