Title: The Case for Change in Chronic Hand Eczema
Steering Committee: Prof. Sonja Molin (Charité Berlin, Germany), Prof. Swen Malte John (Osnabrück University, Germany), Prof. Peter van de Kerkhof (Radboudumc, the Netherlands), Dr Tina Mesarič (Atopika Institute, Slovenia)
Medical Science Officer: Dr Rachel Giles
Medical Project Manager: Dr Maria João Pires
Medical Writer: Robert van den Heuvel
Graphic Design: Caro Grafico | Grafisch Ontwerp
Publication date: 9 June 2026
Executive summary
Chronic hand eczema (CHE) is a prevalent, debilitating inflammatory skin disease that remains widely underrecognised and misunderstood. Despite its high burden, CHE is too often dismissed as a minor skin complaint, leaving patients trapped in prolonged cycles of suboptimal treatment, delayed diagnosis, and diminishing quality of life.
This white paper makes the case for fundamental change in how CHE is understood, diagnosed, and managed. It draws on a synthesis of current scientific evidence and patients’ lived experience, developed with a multidisciplinary Steering Committee of leading dermatologists and a patient representative.
The burden of CHE extends far beyond the skin. Physical symptoms, including pain, itching, fissuring, and impaired hand function, lead to significant occupational, social, and psychological consequences. More than a quarter of patients with CHE are considered unfit for work, while anxiety, embarrassment, and loss of confidence are widely reported. The economic costs to society are substantial, with indirect costs from productivity loss and early retirement accounting for the majority.
A central argument of this paper is that CHE must be recognised as a disease entity distinct from atopic dermatitis of the hands. This distinction has direct implications for diagnosis, classification, and treatment selection. The traditional management framework, which is heavily reliant on topical corticosteroids and a small number of systemic options, is inadequate for many patients and associated with significant adverse effects and high rates of treatment failure.
The emerging era of targeted therapies, most notably the topical Janus kinase (JAK) inhibitor delgocitinib cream, marks a turning point. With a broad mechanism of action, a favourable safety profile, and demonstrated efficacy across CHE subtypes, such agents support earlier intervention and a more patient-centred approach.
This paper, therefore, calls on healthcare professionals to adopt the updated definition of CHE in routine practice, on policymakers to address persistent gaps in diagnosis and access to newer therapies, and on the broader medical community to strengthen collaboration with patient organisations. It also encourages patients to seek timely medical advice, engage in shared decision-making, and advocate for improved awareness and care. Awareness initiatives, such as the first World Chronic Hand Eczema Day on 5 October 2026, provide a timely opportunity to accelerate this change. The time to act is now.