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This month’s email has an eczema theme and highlights delgocitinib, a new treatment option for hand eczema, as well as the latest evidence with respect to bathing frequency in eczema.

Chronic hand eczema (CHE) is one of the most frequent chronic inflammatory skin diseases affecting hands and wrists. CHE is a heterogeneous disease associated with pain, pruritus and substantial occupational, functional, social and psychological burden.

Delgocitinib is a novel topical non‐steroidal pan‐Janus kinase (JAK) inhibitor impacting JAK enzymatic activity and targeting key mediators of CHE with broad anti‐inflammatory effects. Topical delgocitinib cream formulation has been developed to ensure topical absorption at the site of application (i.e. the skin of the hands) and ease of use.

NICE has stated that:

• Delgocitinib can be used, within its marketing authorisation, as an option to treat moderate-to-severe CHE in adults when topical corticosteroids have not worked or are not suitable (delgocitinib can only be used if the company provides it according to the commercial arrangement).
• Delgocitinib should be started and monitored by a healthcare professional with experience in diagnosing and treating CHE in secondary care.
• Consider how skin colour could affect the assessment of severity and make any adjustments needed.

For more information, please see GPnotebook.

Turning to bathing frequency and eczema, most international guidelines recommend bathing daily for about 5–10 minutes with warm water and using emollients immediately afterwards. However, a recent study found that weekly bathing makes no difference to eczema symptoms compared with daily bathing, suggesting that people with eczema can choose the bathing frequency that suits them best. The study authors suggest that this evidence provides reassurance that a consistent bathing routine is not necessary to manage eczema and allows for personal preference.

For more information, please see GPnotebook.

Other highlights in this month’s email include candesartan in the prevention of migraine, maternal paracetamol (acetaminophen) use in relation to autism spectrum and ADHD symptoms in offspring and blood eosinophil count in asthma.

• Blood eosinophil count in asthma: Blood eosinophilia is correlated with an increased risk of asthma exacerbations, so with increasing blood eosinophil counts, exacerbation becomes more severe. The relationship between blood eosinophil count and asthma is described in detail on GPnotebook.
• Delgocitinib for treating moderate-to-severe chronic hand eczema: This new therapy option for management of CHE is summarised on GPnotebook.
• Maternal paracetamol (acetaminophen) use in relation to autism spectrum and ADHD symptoms: GPnotebook provides an evidence review of this controversial topic.
• Mesalazine and intracranial hypertension: This rare possible adverse effect associated with mesalazine use is described.
• Bathing frequency in eczema: Is daily or less frequent bathing indicated for our patients with eczema?
• Candesartan in the prevention of migraine: What is the recommended dose of candesartan in the prevention of migraine? How effective is candesartan in the prevention of migraine?