Diepgen Thomas L, Andersen Klaus E, Chosidow Oliver, Coenraads Peter Jan, Elsner Peter, English John, Fartasch Manigé, Gimenez-Arnau Ana, Nixon Rosemary, Sasseville Denis, Agner Tove
J Dtsch Dermatol Ges. 2015 Jan;13(1):e1-22. doi: 10.1111/ddg.12510_1.
The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). In addition to the evidence- and consensus-based recommendation on the treatment of HE, the guidelines cover mainly consensus-based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non-pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long-term treatment beyond six weeks only when necessary and under careful me-dical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed.The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wis-senschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medi-cal Societies in Germany).No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest.
本指南旨在采用基于证据和共识的方法，对手部湿疹（HE）的管理提供建议。该指南参考了一项关于手部湿疹干预措施的Cochrane系统评价，该评价基于对已发表文献（包括手工检索）的系统检索。除了基于证据和共识的手部湿疹治疗建议外，本指南主要涵盖基于共识的诊断方面和预防措施（一级和二级预防）。治疗建议包括非药物干预、局部、物理和全身治疗。局部用皮质类固醇被推荐为手部湿疹管理的一线治疗方法，但仅在必要时并在仔细的医学监督下进行超过六周的持续长期治疗。对于重度慢性手部湿疹患者，阿利维甲酸被推荐为二线治疗（相对于局部用皮质类固醇）。其他常用的全身治疗方法缺乏随机对照试验（RCT），需要在“头对头 ”RCT中对全身药物进行比较。指南制定小组是欧洲接触性皮炎学会（ESCD）的一个工作组，已仔细尝试调和不同观点，定义当前的最佳实践并提供具体建议，会议由德国科学医学专业协会联合会（AWMF）的专业主持人主持。没有任何医疗公司提供资金支持。本指南预计最迟有效期至2017年12月。
