Do you cycle through topical steroids in patients with CHE, and should the approval of delgocitinib change our approach on this?  

In practice, I do often cycle topical steroids in chronic hand eczema to balance access, efficacy, and safety. Patients are often referred from primary care already having tried multiple topical steroids. Potent topical steroids can help with acute control, but long-term use is problematic. The avai...

Topical steroids are not indicated for chronic use, so I don't recommend them for chronic hand eczema. Having said that, I almost never see a patient who has not tried and failed topical steroids due to the difficulty of treating this condition. It is important to patch test patients with CHE to an...

None of the topicals is effective for CHE. I have recently prescribed Anzupgo cream for a few patients, and so far results are mixed at best. What I do routinely is use intramuscular triamcinolone 80 mg, which will give a long response, and I would wait at least 8 weeks apart. Many of my patients ma...