INTRODUCTION
Chronic hand eczema (CHE) is a common, relapsing inflammatory skin condition characterized by redness, scaling, fissures, and intense itching or pain that can severely impair hand function and quality of life.1,2 It often persists for more than three months or recurs at least twice in a calendar year. High-risk individuals tend to be those with occupational exposure to irritants or allergens.3 Despite its prevalence and impact on patients' lives, treatment options are limited, with many patients showing inadequate response or intolerance to topical corticosteroids and systemic immunosuppressants. As a result, there is a significant unmet need for effective, well-tolerated, safe nonsteroidal therapies that provide long-term disease control with minimal systemic risk.4 This manuscript describes the underlying pathophysiology and clinical phenotypes of CHE, highlighting the complexity and heterogeneity of the disease both from a diagnostic and therapeutic perspective. It also discusses delgocitinib, a topical pan-JAK inhibitor, as the first treatment specifically indicated for CHE approved by the European Medicines Agency (EMA),5 and approved by the FDA in the US in August 2025, offering a multi-pronged anti-inflammatory mechanism and a favorable therapeutic option for this challenging and often debilitating condition.
Epidemiology and Burden of CHE
Hand eczema (HE) is a common inflammatory skin condition with a 1-year prevalence of approximately 9 to 10% in the general population and a lifetime prevalence of up to 14.5%.6,7 Prevalence is higher in women, likely due to differences in occupational and domestic exposures.6,8-10 Moderate to severe disease affects over one-third of patients, and around one-third have a history of atopic dermatitis.7 In children and adolescents, the 1-year prevalence ranges from 5.2% to 10%, with higher risk linked to female sex, childhood eczema, and family history of atopic disease.3 Among individuals aged 70 years and older, 2.7% reported a lifetime diagnosis of hand eczema.
The observational Chronic Hand Eczema epidemiology, Care, and Knowledge of real-life burden (CHECK) study estimated the annual prevalence of CHE across 6 European countries and Canada using a consistent definition and representative sampling.11 Among over 60,000 adults surveyed, 4.7% reported physician-diagnosed CHE, with higher prevalence observed in females, urban residents, employed individuals, and those aged 30 to 39. These findings highlight CHE as a common and potentially underrecognized condition with important demographic patterns.
Epidemiology and Burden of CHE
Hand eczema (HE) is a common inflammatory skin condition with a 1-year prevalence of approximately 9 to 10% in the general population and a lifetime prevalence of up to 14.5%.6,7 Prevalence is higher in women, likely due to differences in occupational and domestic exposures.6,8-10 Moderate to severe disease affects over one-third of patients, and around one-third have a history of atopic dermatitis.7 In children and adolescents, the 1-year prevalence ranges from 5.2% to 10%, with higher risk linked to female sex, childhood eczema, and family history of atopic disease.3 Among individuals aged 70 years and older, 2.7% reported a lifetime diagnosis of hand eczema.
The observational Chronic Hand Eczema epidemiology, Care, and Knowledge of real-life burden (CHECK) study estimated the annual prevalence of CHE across 6 European countries and Canada using a consistent definition and representative sampling.11 Among over 60,000 adults surveyed, 4.7% reported physician-diagnosed CHE, with higher prevalence observed in females, urban residents, employed individuals, and those aged 30 to 39. These findings highlight CHE as a common and potentially underrecognized condition with important demographic patterns.
