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A pilot study on the use of wet wraps in infants with moderate atopic eczema.
Clin Exp Dermatol. 2004 Jul; 29(4):348-53.CE

Abstract

Wet wrap therapy (WWT) is a well-established treatment for severe atopic dermatitis (AD). However little evidence exists to justify widespread use in the community for less severe eczema. We compared the efficacy of WWT with a standard regime of hydrocortisone, to control moderate AD in children. We carried out a single-observer, randomized, controlled pilot study in 19 children under 5 years of age, with AD of 30% or more body surface area, using only 1% hydrocortisone (HC) prior to the study. Group one applied HC once in the morning for 2 weeks, with wet wraps twice daily for week 1, but only at night for week 2. Group two applied HC twice daily without wet wraps. Both applied emollient twice daily and as necessary. The primary outcome measure was the Six Area, Six Sign Atopic Dermatitis (SASSAD) severity score, and the secondary outcome measures were the Infants Dermatology Quality of Life Index (IDQOL), the Dermatitis Family Impact (DFI) score and the weight of topical steroids and emollients used. Over the 2-week active therapy period the mean fall in SASSAD was 8 [95% confidence interval (CI), -18 to +2; P = 0.11] more in the non-WWT group, the median change in the IDQOL was 2 for Group one and 7 for Group two (95% CI for difference, -10 to +3; P = 0.24) and the median change in DFI score was 2 for Group one and 5 for Group two (95% CI for difference, -14 to +2; P = 0.42). This small study has shown that conventional therapy with HC and emollients alone is as effective as WWT for infants with moderately severe, widespread AD, and provides weak evidence to suggest that it may be more effective. We would not advocate routine use of WWT for moderate eczema without further evaluation.

Authors+Show Affiliations

Department of Dermatology, Ninewells Hospital, Dundee, UK. paula_e_beattie@hotmail.comNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15245526

Citation

Beattie, P E., and M S. Lewis-Jones. "A Pilot Study On the Use of Wet Wraps in Infants With Moderate Atopic Eczema." Clinical and Experimental Dermatology, vol. 29, no. 4, 2004, pp. 348-53.
Beattie PE, Lewis-Jones MS. A pilot study on the use of wet wraps in infants with moderate atopic eczema. Clin Exp Dermatol. 2004;29(4):348-53.
Beattie, P. E., & Lewis-Jones, M. S. (2004). A pilot study on the use of wet wraps in infants with moderate atopic eczema. Clinical and Experimental Dermatology, 29(4), 348-53.
Beattie PE, Lewis-Jones MS. A Pilot Study On the Use of Wet Wraps in Infants With Moderate Atopic Eczema. Clin Exp Dermatol. 2004;29(4):348-53. PubMed PMID: 15245526.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A pilot study on the use of wet wraps in infants with moderate atopic eczema. AU - Beattie,P E, AU - Lewis-Jones,M S, PY - 2004/7/13/pubmed PY - 2004/9/8/medline PY - 2004/7/13/entrez SP - 348 EP - 53 JF - Clinical and experimental dermatology JO - Clin Exp Dermatol VL - 29 IS - 4 N2 - Wet wrap therapy (WWT) is a well-established treatment for severe atopic dermatitis (AD). However little evidence exists to justify widespread use in the community for less severe eczema. We compared the efficacy of WWT with a standard regime of hydrocortisone, to control moderate AD in children. We carried out a single-observer, randomized, controlled pilot study in 19 children under 5 years of age, with AD of 30% or more body surface area, using only 1% hydrocortisone (HC) prior to the study. Group one applied HC once in the morning for 2 weeks, with wet wraps twice daily for week 1, but only at night for week 2. Group two applied HC twice daily without wet wraps. Both applied emollient twice daily and as necessary. The primary outcome measure was the Six Area, Six Sign Atopic Dermatitis (SASSAD) severity score, and the secondary outcome measures were the Infants Dermatology Quality of Life Index (IDQOL), the Dermatitis Family Impact (DFI) score and the weight of topical steroids and emollients used. Over the 2-week active therapy period the mean fall in SASSAD was 8 [95% confidence interval (CI), -18 to +2; P = 0.11] more in the non-WWT group, the median change in the IDQOL was 2 for Group one and 7 for Group two (95% CI for difference, -10 to +3; P = 0.24) and the median change in DFI score was 2 for Group one and 5 for Group two (95% CI for difference, -14 to +2; P = 0.42). This small study has shown that conventional therapy with HC and emollients alone is as effective as WWT for infants with moderately severe, widespread AD, and provides weak evidence to suggest that it may be more effective. We would not advocate routine use of WWT for moderate eczema without further evaluation. SN - 0307-6938 UR - https://www.unboundmedicine.com/medline/citation/15245526/A_pilot_study_on_the_use_of_wet_wraps_in_infants_with_moderate_atopic_eczema_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0307-6938&date=2004&volume=29&issue=4&spage=348 DB - PRIME DP - Unbound Medicine ER -