1.1 Alitretinoin is recommended, within its licensed indication, as a treatment option for adults with severe chronic hand eczema that has not responded to potent topical corticosteroids if the person has:
severe disease, as defined by the physician's global assessment (PGA) and
a dermatology life quality index (DLQI) score of 15 or more.
1.2 Alitretinoin treatment should be stopped:
as soon as an adequate response (hands clear or almost clear) has been achieved or
if the eczema remains severe (as defined by the PGA) at 12 weeks or
if an adequate response (hands clear or almost clear) has not been achieved by 24 weeks.
1.3 Only dermatologists, or physicians with experience in both managing severe chronic hand eczema and the use of systemic retinoids, should start and monitor treatment with alitretinoin.
1.4 When using the DLQI, healthcare professionals should take into account any physical, sensory or learning disabilities, or other communication difficulties that could affect the responses to the DLQI. In such cases, healthcare professionals should ensure that the DLQI continues to be a sufficiently accurate measure.