• In general, there is a lack of evidence of comparative advantage for the three most established treatment modalities for hand eczema - topical corticosteroids, topical coal tar and PUVA/UVB.
• Although widely prescribed, there is a lack of evidence of a steroid-sparing effect of emollients.
• There is insufficient clinical evidence for a choice between short bursts of potent topical steroids versus continuous application of mild steroids.
• PUVA and UVB are effective, but there is no evidence of a clinical advantage of one modality over the other.
• There is insufficient evidence for effectiveness of currently marketed retinoids.
• There is insufficient evidence for a comparative advantage of radiotherapy (x rays).
• There is insufficient evidence for oral immunosuppressants as maintenance therapy.
• There is insufficient evidence for low-nickel diet or chelating agents in hand eczema accompanied by nickel allergy.
• Of all the trials that were identified, very few conform to modern quality criteria for an RCT.
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