Pan-JAK Inhibition Across Chronic Hand Eczema and Other Cutaneous Diseases: An Updated Review on Topical Delgocitinib

Chronic hand eczema is a highly prevalent inflammatory skin disorder associated with substantial impairments in quality of life and social interactions. Topical corticosteroids and calcineurin inhibitors are conventional treatments often limited by the achievement of suboptimal disease control and concerns regarding long-term safety. Delgocitinib 2% cream, the first topical pan-Janus kinase inhibitor approved in Europe for adult patients with moderate-to-severe chronic hand eczema, represents a significant therapeutic advance. By simultaneously targeting multiple cytokine pathways implicated in chronic hand eczema pathogenesis, delgocitinib offers a corticosteroid-sparing alternative with minimal systemic absorption. Pivotal phase III clinical trials (DELTA 1, 2, and 3) demonstrated significant reductions in disease severity, itch, and pain compared with baseline, with a favorable safety profile sustained over long-term treatment. Recent investigations in adolescent and Asian populations are further expanding the therapeutic profile of topical delgocitinib across different age groups and ethnic backgrounds. Both the cream and ointment formulations have been assessed in clinical settings, with distinct utility depending on anatomical site and barrier integrity. Beyond chronic hand eczema, topical delgocitinib has shown efficacy in atopic dermatitis, and preliminary evidence is emerging in other inflammatory skin diseases, including vitiligo, lichenoid dermatoses, and hair disorders. This review provides an updated overview of the biological rationale for pan-Janus kinase inhibition, summarizes the most recent outcomes of topical delgocitinib in chronic hand eczema and atopic dermatitis management, and outlines its potential new applications in the landscape of immune-mediated skin diseases.