Background : Hand eczema (HE) is a common skin disease which often needs long term treatment.. There are several reports about the efficacy of topical doxepin in the treatment of pruritic dermal diseases. This study was undertaken to compare the efficacy and safety of 5% doxepin cream and clobetasol 0.05% versus clobetasol 0.05% alone in the treatment of hand eczema.

  Materials and Methods: a randomized double blind placebo-controlled, study was carried out during years of 2011-2012.In total 70 patients with moderate to severe hand dermatitis were selected randomly to be treated with either the doxepin 5% cream+ clobetasol or clobetasol+placebo twice daily for 8 days. Efficacy assessments were performed at baseline and 8days after termination of therapy, according to hand eczema severity index (HECSI) and visual analogue scale (VAS). Statistical analysis was done using SPSS software, version 18.0 and statistical tests including paired T-test and independent T-test.

  Results: Overall, 56 patients completed our study. Out of them 32 were male and 24 were female. The reduction of HECSI score and VAS was statistically significant in the treatment and placebo group (p&le0.05), but differences in HECSI and VAS reduction between treatment and control group were not significant.

Conclusion: Although there is some evidence that doxepin 5% cream is effective in reducing the signs and symptoms of eczematous dermatitis, few trials have been performed. We suggest that in a more extensive clinical trial, the efficacy of this treatment against chronic hand dermatitis be evaluated.