From the Research
Dyshidrotic eczema should be treated with dupilumab, a novel biologic medication, for recalcitrant cases, as it has shown success in treating this condition at standard dosing, according to a recent case report. This approach is based on the most recent evidence available, which suggests that dupilumab can be an effective treatment option for dyshidrotic eczema, a condition that is often challenging to treat and associated with considerable morbidity 1.
Treatment Options
- Topical corticosteroids, such as betamethasone or clobetasol, can be used to reduce inflammation and itching, applied twice daily for 2-4 weeks.
- Oral corticosteroids, like prednisone, may be necessary for severe cases, with a dosage of 20-40mg daily for 1-2 weeks, followed by tapering.
- Moisturizing regularly with fragrance-free emollients is essential to maintain skin barrier function.
- Avoiding triggers, including irritants like soaps, detergents, and frequent water exposure, is crucial.
- Nickel and cobalt in foods can exacerbate symptoms in some patients.
Additional Therapies
- Cold compresses can provide relief during flares.
- Antihistamines, such as hydroxyzine, can help with sleep disruption from itching, with a dosage of 25mg at bedtime.
- For chronic cases, phototherapy or immunosuppressants like tacrolimus ointment might be recommended.
Pathophysiology
Dyshidrotic eczema is believed to result from a combination of genetic predisposition, environmental triggers, and immune system dysfunction, with stress often worsening symptoms. The condition tends to be chronic, with periods of remission and exacerbation. However, dupilumab has shown promise in treating this condition, and its use should be considered for recalcitrant cases, as reported in a recent study 1.