A Review of Current and Emerging Treatments for Managing Pediatric Hand Eczema

Abstract Purpose of Review Pediatric chronic hand eczema (P-CHE) is a debilitating condition that significantly impacts quality of life. Despite its rising prevalence, no P-CHE specific guidelines exist. Current management relies heavily on clinical experience, anecdotal evidence, and extrapolation from adult data. This review aims to identify gaps in P-CHE management and summarize current and emerging therapeutic options. Recent Findings Topical corticosteroids and non-pharmacological measures remain the cornerstone of P-CHE management. Topical calcineurin, topical Janus kinase (JAK) inhibitors, and phototherapy offer steroid-sparring alternatives. Although systemic treatments are often avoided due to safety concerns in children, they are essential for achieving adequate control and symptom management in severe or refractory cases. Alitretinoin, methotrexate, and cyclosporine are used cautiously off-label. Dupilumab, approved for pediatric atopic dermatitis, has shown promising efficacy and safety in P-CHE trials. Similarly, the use of oral JAK-inhibitors is at the forefront of emerging treatment options. Summary Effective P-CHE management requires a multifaceted, patient- and family-centered approach that balances efficacy, safety, and adherence. The literature reflects a critical gap in P-CHE specific data– especially in systemic therapies and non-atopic subtypes. Existing data is primarily derived from limited subgroup analyses within adult predominant trials, or from patients with atopic hand dermatitis enrolled within larger atopic dermatitis studies. Future research must address these gaps to inform guideline development and improve outcomes for affected children.