Journal List > Allergy Asthma Respir Dis > v.7(1) > 1125513

Park and Song: The efficacy of wet wrap therapy in children with atopic dermatitis in a single center

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.

Conclusion

Wet wrap therapy with new garments could be easily done by parents. Wet wrap therapy may be effective and safe in controlling moderate-to-severe AD in children.

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.
aard-7-13f1.tif
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.
aard-7-13f2.tif
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.
aard-7-13f3.tif
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

Values are presented as number (%) or mean±standard deviation.

WWT+, atopic dermatitis patients with wet wrap therapy; WWT-, atopic dermatitis patients with only conventional treatment; SCORAD, SCORing Atopic Dermatitis.

* Chi-square test

Mann-Whitney test.

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

Values are presented as mean±standard deviation.Δ, difference between pretreatment score and posttreatment score; WWT+, atopic dermatitis patients with wet wrap therapy; WWT-, atopic dermatitis patients with only conventional treatment; SCORAD, SCORing Atopic Dermatitis.

* SCORAD index (0–103)=

Objective score (0–83)+

Subjective symptoms (0–20).

Objective score=Extent (0–100)/5+Intensity (0–18)×7/2.

Subjective symptoms= Pruritus (0–10)+Sleep loss (0–10).

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