Topical Corticosteroid-Refractory Chronic Hand Eczema Successfully Treated with Delgocitinib: A Case Report

Background: Chronic hand eczema (CHE) is a heterogeneous, multifactorial inflammatory dermatosis defined by disease lasting >3 months or recurrent flares occurring two or more times within 12 months. Affecting up to 15% of the population during their lifetime, CHE is associated with significant morbidity, including pruritus, pain, sleep disturbance, functional impairment, and reduced quality of life. Although topical corticosteroids remain a mainstay of treatment, prolonged use may contribute to cutaneous atrophy and impaired skin barrier function. Some patients experience persistent or worsening disease despite appropriate use, highlighting the need for nonsteroidal treatment options. Recent recognition of CHE as a distinct disorder has led to the development of targeted therapies, including the topical panJanus kinase (JAK) inhibitor delgocitinib. Case Report: We present the case of a 45-year-old woman with a six-month history of unilateral eczematous dermatitis that persisted despite emollient use and exacerbated following treatment with triamcinolone 0.1% cream and clocortolone pivalate 0.1% cream. Patch testing did not identify relevant allergens, and the morphology supported a diagnosis of CHE. Results: Following initiation of delgocitinib 2% cream twice daily, the patient experienced marked reductions in erythema, scaling, and pruritus within 12 days, with improvement of the Investigator Global Assessment score from 4 to 1, without treatment-related adverse events. Conclusion: This case highlights the potential utility of delgocitinib as a corticosteroidsparing therapeutic option for patients with refractory CHE or intolerance to conventional topical therapies.