The proactive wet-wrap method with diluted corticosteroids versus emollients in children with atopic dermatitis: A prospective, randomized, double-blind, placebo-controlled trial - 14/05/14
, Arjan C. Devillers, MD, PhD e, Dimitris Rizopoulos, PhD c, Marinus C.G. van Praag, MD, PhD f, Dirk Van Gysel, MD, PhD g, Marleen Goeteyn, MD h, Flora B. de Waard-van der Spek, MD, PhD b, dAbstract |
Background |
Wet-wrap treatment (WWT) has been advocated as a relatively effective treatment in children with severe atopic dermatitis (AD). WWT often serves as crisis intervention for AD.
Objectives |
We sought to evaluate the use of WWT with diluted corticosteroids in comparison with emollient in children with severe AD during 4 weeks in a proactive schedule during which the frequency of corticosteroid applications was tapered.
Methods |
A randomized, double-blind, placebo-controlled study was performed in children aged 6 months to 10 years with severe AD (objective SCORAD at least 40 ± 5), comparing WWT with diluted corticosteroids (1:3 mometasone furoate 0.1% ointment and for the face 1:19 mometasone furoate 0.1% ointment under a mask) with emollient (petrolatum 20% in cetomacrogol cream). The primary outcome was improvement of the objective SCORAD; secondary outcomes included Patient-Oriented Eczema Measure and quality-of-life index.
Results |
WWT with diluted corticosteroids acted faster and was more efficacious than WWT with emollients. Best results were obtained in age groups 6 to 9 years and 0 to 3 years. The difference in efficacy evaluated by objective SCORAD was significant at all measuring points. This also applied to the quality-of-life index.
Limitations |
The study group was relatively small.
Conclusions |
WWT for severe AD is an effective therapy option for at least a period of 4 weeks.
Le texte complet de cet article est disponible en PDF.Key words : atopic dermatitis, diluted corticosteroids, emollients, eczema, long-term-intervention, wet-wrap treatment
Abbreviations used : AD, HPA, POEM, QOL, WWT
Plan
| Sherief R. Janmohamed and Arnold P. Oranje contributed equally to this study. |
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| Nonrestricted funds were received from Schering-Plough BV, Fagron, Astellas, Molnlycke, Aardbeesie Project (www.aardbeesie.nl), and Foundation for Pediatric Dermatology Rotterdam (www.pediatric-dermatology.com). |
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| Conflicts of interest: None declared. |
Vol 70 - N° 6
P. 1076-1082 - juin 2014 Retour au numéro
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