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Abstract
Purpose
Wet wrap therapy is a well-known treatment for severe atopic dermatitis (AD). However, wet wrap therapy with usual bandage was a troublesome and time-consuming process of application. The aim of this study was to evaluate the efficacy, safety and convenience of wet wrap therapy with new garments in children with moderate-to-severe AD.
Methods
We compared 56 AD children treated with wet wrap therapy and 14 AD children treated with only conventional therapy. We retrospectively reviewed the clinical features, change of SCORing Atopic Dermatitis (SCORAD) index, adverse effects and parent's reports.
Results
The initial mean SCORAD index was 60.3±15.3 points. No significant differences in sex, age, initial SCORAD index, total eosinophil count, total IgE level, food allergen sensitization, inhalant allergen sensitization or associated allergic diseases were found between the wet wrap and conventional groups. The pharmacological and nonpharmacological interventions except wet wrap therapy were same in the 2 groups. Wet wrap therapy with garments or tubular bandage was easily done one time per day overnight in 10.6±3.5 days by parents. Improvement in total SCORAD index, intensity, subjective symptoms and pruritus were significantly higher in the wet wrap group than in the conventional group (36.2 vs. 26.9, 6.0 vs. 4.0, 9.9 vs. 7.4, and 4.8 vs. 3.6 points). No fol-liculitis and serious adverse effects were reported.
References
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Fig. 1.
Treatment of atopic dermatitis with wet wrap therapy was done as the protocol of Inje University Ilsan Paik Hospital.
Fig. 2.
Tubifast garments (A), Tubifast bandage for limb (B) and/or Tubifast bandage for face (C) were applied according to the lesion of atopic dermatitis.
Fig. 3.
Improvement of total SCORAD index (A), intensity (B), subjective symptoms (C), and pruritus (D) were significantly higher in WWT+ group than in WWT-group (mean pretreatment score to mean posttreatment score; 61.1 to 24.9 vs. 57.1 to 30.1, 10.5 to 4.5 vs. 8.9 to 4.9, 14.2 to 4.3 vs. 14.9 to 7.4, 7.2 to 2.3 vs. 7.4 to 3.8 points). WWT+, atopic dermatitis patients with wet wrap therapy; WWT-, atopic dermatitis patients with only conventional treatment; SCORAD, SCORing Atopic Dermatitis.
Table 1.
Comparison of clinical characteristics between WWT+ and WWT-groups
| Characteristic | WWT+ (n=56) | WWT− (n=14) | P-value |
|---|---|---|---|
| Male sex | 25 (44.6) | 10 (71.4) | 0.073* |
| Age (mo) | 45.5±47.5 | 56.1±53.1 | 0.293† |
| Initial SCORAD index | 61.1±15.9 | 57.1±12.7 | 0.436† |
| Total eosinophil count (/μL) | 890.7±753.7 | 521.4±418.3 | 0.143† |
| Total IgE (IU/mL) | 489.7±1,067.3 | 517.4±746.1 | 0.909† |
| Food allergen sensitization | 19 (33.9) | 4 (28.6) | 0.640† |
| Inhalant allergen sensitization | 16 (28.6) | 4 (28.6) | 0.959† |
| Allergic rhinitis | 13 (23.2) | 5 (35.7) | 0.338† |
| Bronchial asthma | 7 (12.5) | 0 (0) | 0.163† |
| Food allergy | 13 (23.2) | 5 (35.7) | 0.338† |
Table 2.
Comparison of improvement of outcomes between WWT+ and WWT-groups
| Outcome | WWT+ (n=56) | WWT− (n=14) | P-value |
|---|---|---|---|
| Δ SCORAD index* | 36.2±13.9 | 26.9±13.8 | 0.033 |
| Δ Objective score† | 25.7±12.4 | 19.5±10.6 | 0.097 |
| Δ Extent | 26.6±24.5 | 27.1±29.0 | 0.977 |
| Δ Intensity | 6.0±2.9 | 4.0±1.8 | 0.023 |
| Δ Subjective symptoms‡ | 9.9±3.8 | 7.4±4.1 | 0.037 |
| Δ Pruritus | 4.8±1.9 | 3.6±2.0 | 0.030 |
| Δ Sleep loss | 5.0±2.1 | 3.9±2.2 | 0.071 |
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