Treatment of atopic eczema with oral alitretinoin

Conflicts of interest: M.G. and A.W. have received financial support and S.M., J.C.P. and T.R. have conducted clinical trials with alitretinoin and have received financial support from Basilea Pharmaceuticals GmbH, the manufacturer of oral alitretinoin. However, there was no financial support for the clinical observation submitted here. Madam, Chronic hand eczema (CHE) is a distressing disease of the palms with variable aetiology, severity and morphology. Clinical phenotypes essentially distinguish hyperkeratotic and dyshidrotic or mixed disease patterns. The underlying disease mechanisms include allergic contact dermatitis, irritative damage and atopy.1 Alitretinoin (9‐cis retinoic acid) is a novel antagonist vitamin A derivative, which binds both retinoic acid receptors (RAR) and retinoid X receptors (RXR). It has recently been licensed for oral treatment of CHE in several European countries.2 The clinical efficacy of alitretinoin for CHE has been confirmed in two large, randomized, double‐blinded, placebo‐controlled, clinical trials.3, 4 We wondered if oral alitretinoin would also be effective in extrapalmar atopic eczema (AE) lesions of patients with atopic CHE, or if side‐effects would limit its potential use in AE.