In this episode of Derms and Conditions, host Dr James Del Rosso speaks with Dr Linda Stein Gold, Director of Dermatology at Henry Ford Health, to unpack one of dermatology’s most frustrating and multifactorial conditions: chronic hand eczema.

They explore why chronic hand eczema isn’t a single disease but a spectrum of overlapping etiologies—ranging from atopic dermatitis and irritant or allergic contact dermatitis to more elusive triggers. Dr Stein Gold shares practical strategies for teasing out potential causes, discusses some potential limitations of patch testing, and highlights the importance of patient history and thorough skin assessment.

The conversation also covers current treatment approaches, from topical corticosteroids to systemic therapies, and introduces delgocitinib cream, a pan-JAK inhibitor under FDA review, as a unique and valuable nonsteroidal option. Drs Stein Gold and Del Rosso explain how its broad immunomodulatory action may help address the condition’s diverse inflammatory pathways while remaining well tolerated, even on fissured skin.

Whether you're managing stubborn cases or looking for updates on investigational therapies, this episode offers practice-ready recommendations for clinicians and a reminder not to overlook the emotional toll of hand eczema on patients’ daily lives.