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
Abstract |
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 numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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