Alitretinoin in hand eczema

• alitretinoin is a derivative of retinoic acid (9-cis-retinoic acid) that binds to and activates intracellular retinoid receptors. These receptors regulate cellular differentiation and proliferation
• 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 (1)
• 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)
• adverse effects
  • most frequent adverse effects seen with alitretinoin include headache, dry mouth, anaemia, flushing and erythema. Hyperlipidaemia has also been observed. Adverse effects are generally dose related and reversible
  • alitretinoin is teratogenic and therefore contraindicated in women of childbearing potential unless all of the conditions of the Pregnancy Prevention Programme (as outlined in the SPC) are met. Alitretinoin should not be prescribed if the person's eczema can be adequately controlled by standard measures, including skin protection, avoiding allergens and irritants, and treatment with potent topical corticosteroids

For full details of side effects and contraindications, see the SPC

Reference:

1. NICE (August 2009). Alitretinoin for the treatment of severe chronic hand eczema