Jo Mingyul, Kang Ho Song, Kim Min-Soo, Park Hyang-Joon, Jue Mihn-Sook
Department of Dermatology, Veterans Health Service Medical Center, Seoul, Korea.
Division of Dermatology, Department of Medicine, Hanyang University Graduate School, Seoul, Korea.
Ann Dermatol. 2019 Dec;31(6):595-600. doi: 10.5021/ad.2019.31.6.595. Epub 2019 Oct 31.
Chronic hand eczema (CHE) tends to be refractory to conventional therapy. Previous clinical trials have found that alitretinoin is an effective and well-tolerated treatment for CHE. However, there is a relative lack of data on the effectiveness of alitretinoin in elderly patients.
The aim of this study was to investigate the efficacy and safety of oral alitretinoin in elderly patients with moderate to severe CHE in Korea.
We retrospectively investigated 46 CHE patients who were treated with either 10 mg or 30 mg of alitretinoin between June of 2016 and July of 2018. The physician's global assessment (PGA) was used to evaluate treatment efficacy. All adverse events were retrospectively evaluated with respect to laboratory testing, including complete blood cell count, fasting blood chemistry, lipid profile, and liver and thyroid function tests.
The mean patient age in this study was 71.0±5.1 years. The treatment period was over eight weeks. A total of 38 of 46 patients (82.6%) exhibited clinical improvement with PGA ratings of 'clear' or 'almost clear.' There were 13 patients (28.3%) who experienced an adverse effect, with the most common being headache (13.0%) and gastrointestinal symptoms (8.7%) followed by xerosis (6.5%). A total of 13 patients developed or exhibited worsening hypertriglyceridemia (28.3%).
Alitretinoin can be considered a safe and effective treatment option in elderly patients with moderate to severe CHE.
慢性手部湿疹（CHE）往往对传统疗法难治。既往临床试验发现，阿维A是一种治疗CHE有效且耐受性良好的药物。然而，关于阿维A在老年患者中的有效性数据相对缺乏。
本研究旨在调查口服阿维A在韩国老年中重度CHE患者中的疗效和安全性。
我们回顾性研究了2016年6月至2018年7月间接受10mg或30mg阿维A治疗的46例CHE患者。采用医生整体评估（PGA）来评估治疗效果。所有不良事件均通过实验室检查进行回顾性评估，包括全血细胞计数、空腹血液化学、血脂谱以及肝脏和甲状腺功能检查。
本研究中患者的平均年龄为71.0±5.1岁。治疗期超过8周。46例患者中有38例（82.6%）临床症状改善，PGA评分为“清除”或“基本清除”。有13例患者（28.3%）出现不良反应，最常见的是头痛（13.0%）和胃肠道症状（8.7%），其次是皮肤干燥（6.5%）。共有13例患者出现或表现出血清甘油三酯升高加重（28.3%）。
阿维A可被视为老年中重度CHE患者安全有效的治疗选择。
