Delgocitinib Offers Targeted Relief for the Painful Burden of Chronic Hand Eczema

In a recent Dermatology Times Expert Perspectives custom video series, Omar Noor, MD, a board-certified dermatologist and co-owner of Rao Dermatology in New York, discussed the importance of assessing pain in patients with chronic hand eczema (CHE), how he decides to initiate delgocitinib cream (Anzupgo; LEO Pharma), his patients’ experiences with the application of delgocitinib, and his message to colleagues about minimal systemic absorption.

Noor first discussed how CHE differs from atopic dermatitis not only in its heterogeneity but also in pain. Although itch is a defining feature of atopic dermatitis, he noted that patients with CHE frequently report deep fissures, bleeding, burning with routine handwashing or sanitizer use, and sharp pain that limits daily function.

"When I'm counseling my patients about their chronic hand eczema, it's not just about promising less itch. I'm talking about reducing stinging and burning with everyday tasks, allowing fissures to close so that they can grip things, so they can wash their hands without sharp pain, and they can improve their sleep," Noor said.

Noor explained that treatment decisions begin with assessing chronicity and functional limitation, given the essential role of the hands in work and everyday tasks. Prior corticosteroid use often signals the need to shift toward a targeted, nonsteroidal chronic-use therapy. In this context, delgocitinib cream serves as a practical long-term option, according to Noor.

He reported favorable clinical experience with delgocitinib, citing early improvements in itch and burning—sometimes within days—and gradual reductions in fissuring, scaling, and vesiculation. Noor’s patients consistently comment on the cream’s non-greasy formulation, which allows them to immediately resume tasks such as typing and phone use without residue. This positive tactile experience reinforces adherence, ultimately improving outcomes.

Noor also highlighted the importance of distinguishing topical delgocitinib from systemic JAK inhibitors. As a locally acting agent with minimal systemic absorption, it enables clinicians to apply JAK-STAT pathway modulation without concerns associated with systemic immunomodulators or comorbid conditions. He emphasized that patient reassurance around this safety profile is a crucial component of effective shared decision-making in CHE management.