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