Treatment of chronic and recalcitrant fissures of eczema by topical timolol

Background Eczema is a common skin disease characterized by cutaneous dry and itchy patches. This disease weakens the skin barrier function and may be associated with Fissures. Topical timolol has been found to help wound healing. Aim To assess the efficacy and safety of topical timolol application in chronic, recalcitrant fissures and erosions of hand and foot eczema. Patients and methods The current study was conducted on 20 patients who had chronic, recalcitrant, fissures (had been present for at least 1 month), which were painful and recalcitrant to the application of skin moisturizer and conventional treatment of eczema. Typical clinical features of eczema were used to diagnose the patients. At bedtime, we instruct the patients to apply three drops of 0.5% timolol ophthalmic solution over each fissure/erosion. Patients were advised not to come into contact with irritants. We observed healing of erosions and fissures weekly till improvement (complete healing). Photographs were taken of all patients at baseline and after healing. Results The duration of treatment of fissures of eczema patients ranged from 1.0 to 4.0 weeks, with a mean±SD of 2.55±0.27 weeks, 16 patients had one fissure, three patients had two fissures, and one patient had three fissures, 17 patients had fissures on their hands, and three patients had fissures on their feet. Four patients had a history of atopy. Eighteen patients improved with treatment by topical timolol, while two patients with single fissure did not improve. One of these patients who did not improve discontinued the drug due to the development of hypotension. Conclusion Topical timolol could be used as an efficient, pain-relieving, and cheap modality in the treatment of recalcitrant fissures and erosions of chronic hand eczema.