Alitretinoin — SCE Dermatology MCQ
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Correct answer: B — An oral retinoid (9-cis retinoic acid) specifically licensed for severe chronic hand eczema refractory to potent topical corticosteroids
Alitretinoin (Toctino, 9-cis retinoic acid) is the only oral retinoid specifically licensed for severe chronic hand eczema that has not responded to potent topical corticosteroids. NICE TA177 approved it for adults with severe CHE unresponsive to treatment. Dose: 30 mg daily for 12-24 weeks. The BACH trial demonstrated significant improvement in hand eczema severity and quality of life. As a retinoid, it is teratogenic — the Pregnancy Prevention Programme applies. Side effects include headache, dry lips, musculoskeletal pain, and hyperlipidaemia. It can be repeated for relapse. Alitretinoin fills an important therapeutic gap between topical therapy and broader immunosuppression for this disabling condition.
Reference: NICE TA177 Alitretinoin; BAD