Stege H
Hautklinik, Klinikum Lippe-Lemgo, Rintelner Strasse 85, 32657, Lemgo, Deutschland.
Hautarzt. 2008 Sep;59(9):696-702. doi: 10.1007/s00105-008-1558-3.
Treatment of hand eczema is dominated by the administration of topical glucocorticosteriods. If topical treatment fails, the best second-line option is ultraviolet (UV) therapy alone or as combination therapy. UVB and PUVA (psoralen plus UVA) therapy is effective and has relatively few side effects. Due to the localized nature of the disease, topical PUVA therapy is preferable to systemic PUVA treatment. Among the topical methods, cream PUVA therapy is simple, safe and highly effective. Recent clinical studies have demonstrated the therapeutic efficacy of a new retinoid called alitretinoin, a 9-cis-retinoic acid. However, even this form of treatment does not lead to a complete cure in all patients. Under the primacy of multimodal treatment, UV therapy should be administered as combination therapy if oral retinoids are not sufficiently effective.
手部湿疹的治疗主要以局部使用糖皮质激素为主。如果局部治疗失败,最佳的二线选择是单独使用紫外线(UV)疗法或作为联合疗法使用。UVB和PUVA(补骨脂素加UVA)疗法有效且副作用相对较少。由于该疾病的局限性,局部PUVA疗法优于全身PUVA治疗。在局部治疗方法中,乳膏PUVA疗法简单、安全且高效。最近的临床研究证实了一种名为阿利维A酸(9-顺式维甲酸)的新型维甲酸的治疗效果。然而,即使是这种治疗形式也不能使所有患者完全治愈。在多模式治疗为主的情况下,如果口服维甲酸效果不够显著,紫外线疗法应作为联合疗法使用。