A 24 Week Trial to Compare the Efficacy and Safety of Delgocitinib Cream 20 mg/g Twice-daily With Alitretinoin Capsules Once-daily in Adult Participants With Severe Chronic Hand Eczema

Main inclusion criteria:

• Diagnosis of CHE, defined as hand eczema that has persisted for more than 3 monthsor returned twice or more within the last 12 months.

• Disease severity graded as severe at screening and baseline according to IGA-CHE (i.e. an IGA-CHE score of 4).

• Participants who have a documented recent history of inadequate response totreatment with topical corticosteroids (TCS) or for whom TCS are documented to beotherwise medically inadvisable (e.g. due to important side effects or safetyrisks).

• Participants adherent to standard non-medicated skin care including avoidance ofknown and relevant irritants and allergens.

• Participants must use contraceptive methods in accordance with local regulationsregarding the methods of contraception for those participating in clinical studies

Main exclusion criteria:

• Concurrent skin diseases on the hands, e.g. tinea manuum.

• Active atopic dermatitis requiring medical treatment in regions other than the handsand feet.

• Active psoriasis on any part of the body.

• Hyperkeratotic hand eczema in combination with a history of psoriasis on any part ofthe body.

• Clinically significant infection on the hands.

• Participants who cannot receive alitretinoin.

• Clinically significant infection within 28 days prior to baseline which, in theopinion of the investigator, may compromise the safety of the participant in thetrial, interfere with evaluation of the IMP, or reduce the participant's ability toparticipate in the trial.

• History of any known primary immunodeficiency disorder including a positive humanimmunodeficiency virus (HIV) test at screening, or the participant takingantiretroviral medications as determined by medical history and/or participant'sverbal report.

• Any disorder which is not stable and could:

• Affect the safety of the participant throughout the trial.

• Impede the participant's ability to complete the trial.

• Positive hepatitis B surface antigen or hepatitis C virus antibody serology atscreening.

• Systemic treatment with immunosuppressive drugs, immunomodulating drugs, retinoids,or corticosteroids within 28 days prior to baseline.

• Use of tanning beds, phototherapy, or bleach baths on the hands within 28 days priorto baseline.

• Previous or current treatment with Janus kinase (JAK) inhibitors (includingdelgocitinib/LEO 124249), systemic or topical.

• Cutaneously applied treatment with immunomodulators or TCS on the hands within 14days prior to baseline.

• Use of systemic antibiotics or cutaneously applied antibiotics on the hands within 14 days prior to baseline.

• Other transdermal or cutaneously applied therapy on the hands (except for the use ofsubject's own emollients) within 7 days prior to baseline.

• Cutaneously applied treatments in regions other than the hands, which couldinterfere with clinical trial evaluations or pose a safety concern within 7 daysprior to baseline.

• Treatment with any marketed biological therapy or investigational biologic agents:

• Any cell-depleting agents: within 6 months prior to baseline, or untillymphocyte count returns to normal, whichever is longer.

• Other biologics: within 3 months or 5 half-lives, whichever is longer, prior tobaseline.

• Previously used alitretinoin or participated in a clinical trial with alitretinoinor delgocitinib.