<unk>  is a complex condition, and treatment should only be administered by a dermatologist with specialist knowledge. Treatment may be very costly. Treatment should follow certain basic principles, and chronic and severe cases of<unk>  in particular require complex treatment concepts. Besides skin care,<unk>  protection, and external (topical) applications with preparations containing effective ingredients or light therapy, an internal (systemic) therapy may be considered. Avoidance of catalysts, basic procedures, and skin protection Of primary importance is the strict removal and avoidance of catalysts for the development of chronic<unk> , such as skin-irritating damage, excessive contact with water, or proven allergenic substances. Treatment of every type of<unk>  and degree of severity must include sustainable replenishment of the natural oils and moisture contained in the skin with creams and salves free of fragrances and preservatives; this is an essential basic step. In addition, protection procedures developed especially for the individual's skin stresses must be applied, e.g. use of cotton or hypoallergenic plastic gloves. Depending on the individual's own needs, these procedures should continue after the<unk>  heals, since they will also have a preventive effect. External treatment External treatment should be oriented primarily according to the prevailing signs of illness. In the case of blister forming, drying treatments such as<unk>  baths containing synthetic tannins or oily-moist preparations may hinder itching. If callus development exhibiting tear formation is present, the focus should be on softening the skin with preparations containing urea or salicylic acid. In order to reduce inflammation, creams and salves containing cortisone are often very effective. Topical corticosteroids are a standard treatment for<unk> , but their efficacy in comparison to UV phototherapy is not clear. Severe and chronic cases seldom respond sufficiently and require long periods of treatment which can increase the risk of side effects occurring. In individual cases, and especially in the case of atopic<unk> , the dermatologist may prefer to use cortisone-free, anti-inflammatory creams or salves, which include calcineurin inhibitors tacrolimus or pimecrolimus. A 55 patient trial found topical bexarotene 1% gel monotherapy to be effective and well-tolerated (79% response rate for ≥50% clinical improvement; 39% response rate for ≥90% improvement). Phototherapy Phototherapy can be effective in the treatment of chronic<unk> . However, not all dermatologists or dermatology clinics offer this form of therapy, and it involves extended periods of treatment for the patient. A period of four to six weeks should involve 3–4 radiation sessions. The most frequently applied form of light therapy is PUVA therapy. This first treats the<unk> s with a cream that contains an ingredient that causes the skin to become light-sensitive, the<unk> s are then irradiated with ultraviolet A light (UV-A). After two days of treatment, a pause of one day must occur. Due to possible risks such as premature skin aging or chronic light damage caused to the skin, phototherapy cannot be considered for the long term. Systemic treatment Besides skin care, skin protection, and an external treatment, severe and chronic cases of<unk>  often also require systemic treatment. Various preparations are available for this. For acute, severe episodes exhibiting blister formation, internal cortisone preparations, sometimes in combination with certain antibiotics, may be helpful in the short term. The active agent ciclosporin, which is approved for treatment of severely pronounced neurodermitis, may also be used for severe, atopic<unk> . Other substances that suppress the immune system have also shown effectiveness in some cases. However, these substances are not approved for<unk> . In the last couple of years an internal medicine has been approved for the first time for the treatment of chronic<unk> . This involves a derivative of vitamin A, called alitretinoin, which is also naturally present in the human body. Alitretinoin can be used to treat all forms of severe chronic<unk>  which have not reacted to external cortisone preparations. The effectiveness of this form of treatment has been tested extensively in clinical study programs and proven prior to its approval. The trial results showed that two thirds of patients did not suffer a recurrence 6 months after application of the medication, and that re-treatment is effective if<unk>  reoccurs. The duration of alitretinoin treatment is 3 to 6 months. During treatment and one month prior to beginning and one month after completion, women of childbearing-age must use contraceptives and also test for pregnancy each month since, as with all derivatives of vitamin A, the substance involved is teratogenic. Side effects mainly include temporary headaches during the initial days of treatment, as well as a possible increase in blood fat and cholesterol values. Regular laboratory tests of blood values are recommended to monitor this.
Hand eczema
Xerotic eczema
Noxzema
Dermatitis repens
Phototoxic tar dermatitis
Palmoplantar keratoderma
Pachyderma
Cutaneous larva migrans