Abstract
Delgocitinib is a pan-Janus kinase inhibitor approved for moderate-to-severe chronic hand eczema (CHE) in adults. However, real-world evidence remains limited. We prospectively evaluated 149 adult patients (mean age: 46.4 years; 60.4 % female) treated with delgocitinib for chronic hand eczema across 20 Italian dermatology centres between May and November 2025, with a four-month follow-up. Two-thirds of patients were non-occupationally exposed, and>80% had vesicular or atopic chronic hand eczema. At week 4, Physician Global Assessment (PGA)-chronic hand eczema 0/1 and Hand Eczema Severity Index (HECSI)-75 were achieved in 42.3% and 43.8% of patients, increasing significantly to 74.3% and 88.0% at week 16. Pruritus and pain Numerical Rating Scale (NRS) 0/1 were reported in 43.8% and 52.3% of patients at week 4, rising significantly to 74.4% and 86.5% at week 16. Hand Eczema Symptom Diary–Patient Global Impression of Severity (HESD PGI-S) 0/1 increased from 45.6% to 76.6%. Non-occupationally exposed patients showed significantly higher early response rates than occupationally exposed, with attenuation of differences by week 16. HECSI-75 responses were consistent across chronic hand eczema subtypes, particularly vesicular (94.0%) and atopic (90.0%). Treatment was well tolerated, with rare and no severe adverse events reported. These findings support delgocitinib as a rapid, effective and safe treatment option for chronic hand eczema.