Treatment
- #1 avoidance of trigger
- Physical skin protection
- Emollients/Barrier creams
- Topical corticosteroids (TCS)
- Resistant chronic dermatitis: NB-UVB or PUVA
- Hyperkeratotic palmoplantar dermatitis: acitretin and alitretinoin or systemic immunomodulators (methotrexate, cyclosporine) or biologic therapy
Prognosis
- “Accommodation” or “hardening”: spontaneously resolve even with continuous exposure
- Worse prognosis for resolution: previous history of atopy, female sex, and coexistence of ACD