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2026, Vol: 10, Issue: 7
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Review Article
Online Published: 01 May 2026
 


Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis

Rama A. Khalil Alamri, Ahmed M. Kedwany, Belal Mohamed Hamed, Manar Alali, Mohammed A. Alanazi, Jood A. Mashoon Shen, Aryaf A. Alshammari, Teif M. Alghamdi, Hanouf A. Althobaiti, Shrooq Tail Alkhodaidi.


Abstract
Alitretinoin, a vitamin A derivative, is used as a systemic option for severe chronic hand eczema (CHE) that does not respond adequately to topical therapies. Prior evidence suggests it can lead to substantial lesion clearance in roughly half of treated patients, but its use may be limited by adverse effects such as headache and changes in lipid profiles. This systematic review and meta-analysis re-examined the overall efficacy and safety of alitretinoin in CHE using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided approach. PubMed, Web of Science, and Scopus were searched for relevant studies evaluating ali tretinoin in CHE. Eligible studies were screened, assessed for risk of bias, and pooled using random-effects meta-analysis in R. From 464 identified records, 10 studies encompassing 2,831 patients met inclusion criteria. Pooled results indicated that 60.7% of patients achieved “clear” or “almost clear” disease according to the Physician Global Assessment after alitretinoin treatment. Adverse events were reported in 8.4% of patients, with headache and dry skin being the most common. Treatment discontinuation due to side effects occurred in 8.0% of patients. Between-study heterogeneity was high for both efficacy and adverse event rates, suggesting variability in treatment response and reporting across studies, while variation was low for discontinuation rates, implying more consistent findings regarding safety-related withdrawal. Overall, alitretinoin appears to be an effective and relatively well-tolerated systemic therapy for CHE, providing meaningful clinical improvement for many patients and remaining a practical option when standard treatments fail.

Key words: Alitretinoin, chronic hand eczema, review


 
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How to Cite this Article
Pubmed Style

Alamri RAK, Kedwany AM, Hamed BM, Alali M, Alanazi MA, Shen JAM, Alshammari AA, Alghamdi TM, Althobaiti HA, Alkhodaidi ST. Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis. IJMDC. 2026; 10(7): 1938-1947. doi:10.24911/IJMDC.51-1771256957

Web Style

Alamri RAK, Kedwany AM, Hamed BM, Alali M, Alanazi MA, Shen JAM, Alshammari AA, Alghamdi TM, Althobaiti HA, Alkhodaidi ST. Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis. https://www.ijmdc.com/?mno=310767 [Access: July 08, 2026]. doi:10.24911/IJMDC.51-1771256957

AMA (American Medical Association) Style

Alamri RAK, Kedwany AM, Hamed BM, Alali M, Alanazi MA, Shen JAM, Alshammari AA, Alghamdi TM, Althobaiti HA, Alkhodaidi ST. Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis. IJMDC. 2026; 10(7): 1938-1947. doi:10.24911/IJMDC.51-1771256957


Vancouver/ICMJE Style

Alamri RAK, Kedwany AM, Hamed BM, Alali M, Alanazi MA, Shen JAM, Alshammari AA, Alghamdi TM, Althobaiti HA, Alkhodaidi ST. Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis. IJMDC. (2026), [cited July 08, 2026]; 10(7): 1938-1947. doi:10.24911/IJMDC.51-1771256957


Harvard Style

Alamri, R. A. K., Kedwany, . A. M., Hamed, . B. M., Alali, . M., Alanazi, . M. A., Shen, . J. A. M., Alshammari, . A. A., Alghamdi, . T. M., Althobaiti, . H. A. & Alkhodaidi, . S. T. (2026) Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis. IJMDC, 10 (7), 1938-1947. doi:10.24911/IJMDC.51-1771256957


Turabian Style

Alamri, Rama A. Khalil, Ahmed M. Kedwany, Belal Mohamed Hamed, Manar Alali, Mohammed A. Alanazi, Jood A. Mashoon Shen, Aryaf A. Alshammari, Teif M. Alghamdi, Hanouf A. Althobaiti, and Shrooq Tail Alkhodaidi. 2026. Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis. International Journal of Medicine in Developing Countries, 10 (7), 1938-1947. doi:10.24911/IJMDC.51-1771256957


Chicago Style

Alamri, Rama A. Khalil, Ahmed M. Kedwany, Belal Mohamed Hamed, Manar Alali, Mohammed A. Alanazi, Jood A. Mashoon Shen, Aryaf A. Alshammari, Teif M. Alghamdi, Hanouf A. Althobaiti, and Shrooq Tail Alkhodaidi. "Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis." International Journal of Medicine in Developing Countries 10 (2026), 1938-1947. doi:10.24911/IJMDC.51-1771256957


MLA (The Modern Language Association) Style

Alamri, Rama A. Khalil, Ahmed M. Kedwany, Belal Mohamed Hamed, Manar Alali, Mohammed A. Alanazi, Jood A. Mashoon Shen, Aryaf A. Alshammari, Teif M. Alghamdi, Hanouf A. Althobaiti, and Shrooq Tail Alkhodaidi. "Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis." International Journal of Medicine in Developing Countries 10.7 (2026), 1938-1947. Print. doi:10.24911/IJMDC.51-1771256957


APA (American Psychological Association) Style

Alamri, R. A. K., Kedwany, . A. M., Hamed, . B. M., Alali, . M., Alanazi, . M. A., Shen, . J. A. M., Alshammari, . A. A., Alghamdi, . T. M., Althobaiti, . H. A. & Alkhodaidi, . S. T. (2026) Efficacy and safety of 9-cis-retinoic acid in chronic hand eczema: a systematic review and meta-analysis. International Journal of Medicine in Developing Countries, 10 (7), 1938-1947. doi:10.24911/IJMDC.51-1771256957




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