Hand Eczema — SCE Dermatology MCQ

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ModerateDermatopharmacologyHand EczemaSCE Dermatology

A 43-year-old woman presents with recalcitrant hand eczema affecting the palms. She is a healthcare worker who washes her hands frequently. Patch testing is negative. She has failed potent topical corticosteroids and hand PUVA. What oral retinoid may be considered?

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Correct answer: A — Alitretinoin

The best answer is “Alitretinoin”. Eczema treatment is selected by site and severity, with topical corticosteroid or calcineurin-inhibitor safety, infection, adherence, contact allergy and psychosocial effects considered before escalation. The alternatives “Bexarotene”, “Tretinoin”, “Acitretin”, “Isotretinoin” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE CG57 atopic eczema recommendations: https://www.nice.org.uk/guidance/cg57/chapter/Recommendations