How is second line treatment of CD?

PUVA, azathioprine, methotrexate and ciclosporin are used for steroid-resistant chronic hand dermatitis. Several prospective clinical trials to support these treatments. Grenz rays (X-rays produced at low kev, low penetration power) for chronic hand dermatitis showed a significantly better response with this therapy compared with use of topical corticosteroids. Alitretinoin is an endogenous acts as pan-agonist at retinoid receptors, binding with high affinity to both retinoic acid receptors and retinoid X receptor Nickel elimination diets