A NEW retrospective real-world study has found that topical delgocitinib offers comparable short-term effectiveness to localized cream psoralen–ultraviolet A (PUVA) therapy in patients with chronic hand eczema (CHE), while showing a trend toward greater quality-of-life improvement.
CHE remains a challenging condition to manage, particularly in patients who do not respond to or cannot tolerate topical corticosteroids. Delgocitinib, the first topical Janus kinase (JAK) inhibitor approved for CHE, provides a steroid-free alternative, but direct comparisons with established therapies such as PUVA have been lacking.
Delgocitinib vs PUVA: Real-World Comparison in Chronic Hand Eczema
In this study, researchers analysed routine-care data from a tertiary centre, including patients with moderate-to-severe CHE treated between 2024 and 2025. Twenty-two patients received twice-daily topical delgocitinib, while a matched group underwent 20–25 sessions of localized cream PUVA alongside as-needed topical corticosteroids. Outcomes were assessed over 12 weeks using the Physician’s Global Assessment (PGA), Dermatology Life Quality Index (DLQI), and symptom scores for itch, pain, and sleep disturbance.
Both treatments led to significant improvements across all measured endpoints (p<0.001). Clinical response rates were similar, with 82% of patients in the delgocitinib group achieving clear or almost clear skin (PGA 0/1), compared with 73% in the PUVA group. Improvements in DLQI were numerically greater with delgocitinib, with a median reduction of 10 points versus 7.5 for PUVA, although this difference was not statistically significant.
A clinically meaningful improvement in quality of life (≥4-point DLQI reduction) was observed in 91% of patients treated with delgocitinib, compared with 77% in the PUVA group. Notably, relapses were more frequent following PUVA therapy.
Among patients treated with delgocitinib, most responders continued low-frequency proactive treatment to maintain disease control, and one patient remained clear three months after discontinuation. Two non-responders subsequently improved with alitretinoin.
Implications for Personalised Treatment Strategies in CHE
Overall, the findings suggest that delgocitinib is an effective alternative to PUVA in routine practice, with potential advantages in sustaining remission. The authors highlight the importance of tailoring treatment strategies to disease subtype to further optimise outcomes in CHE.
Reference
Weißinger S et al. A Retrospective Real-World Comparison of Topical Delgocitinib and Localized Cream Psoralen–Ultraviolet A in Chronic Hand Eczema. Dermatol Ther (Heidelb). 2026; doi: 10.1007/s13555-026-01705-1
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