Ryan Caitriona, Shaw Richard E, Cockerell Clay J, Hand Shari, Ghali Fred E
Department of Dermatology, Baylor University Medical Center, Dallas, TX 75246, USA.
Pediatr Dermatol. 2013 May-Jun;30(3):308-15. doi: 10.1111/pde.12150.
The intermittent use of dilute sodium hypochlorite "bleach baths" has shown efficacy as adjunctive therapy for atopic dermatitis (AD). This feasibility study evaluated the clinical response and patient acceptability of treatment with a cleansing body wash containing sodium hypochlorite in children with AD. This was a 12-week open-label feasibility study of 18 children with AD conducted in a pediatric dermatology outpatient clinic between May 2011 and July 2012. Children with moderate to severe AD, defined as an Investigator Global Assessment (IGA) score of at least 3 on a 5-point scale, who were age 6 months and older and had lesional cultures positive for Staphylococcus aureus at baseline were included. Patients were instructed to wash 3 days/week for 12 weeks with the sodium hypochlorite-containing cleansing body wash. During the study period, patient's individualized topical and systemic treatment regimens were continued. Clinical response to treatment was measured using an IGA score and the percentage of body surface area (BSA) affected. Parents were also administered a retrospective questionnaire evaluating acceptability of the product. There was a statistically significant reduction in IGA score at all time points, with an overall mean reduction from baseline to final measurement using the last observation carried forward in all patients of 1.0 (p = 0.001, n = 18). Similarly the mean reduction of BSA affected was 14.8% (p = 0.005, n = 18). Parents reported that the body wash was significantly easier to use than traditional bleach baths (p < 0.001). The significant reductions in clinical disease severity scores with use of this formulation are encouraging.
间歇性使用稀释的次氯酸钠“漂白浴”已被证明可作为特应性皮炎(AD)的辅助治疗方法。本可行性研究评估了含次氯酸钠的清洁沐浴露治疗AD患儿的临床反应和患者接受度。这是一项于2011年5月至2012年7月在儿科皮肤科门诊对18例AD患儿进行的为期12周的开放标签可行性研究。纳入了年龄在6个月及以上、中度至重度AD患儿,定义为研究者整体评估(IGA)评分为5分制中至少3分,且基线时病变部位金黄色葡萄球菌培养阳性的患儿。患者被指示每周使用含次氯酸钠的清洁沐浴露洗澡3天,共12周。在研究期间,继续患者个体化的局部和全身治疗方案。使用IGA评分和受影响的体表面积(BSA)百分比来衡量治疗的临床反应。还向家长发放了一份回顾性问卷,评估产品的可接受性。所有时间点的IGA评分均有统计学显著降低,所有患者从基线到最终测量(采用末次观察向前结转)的总体平均降低值为1.0(p = 0.001,n = 18)。同样,受影响的BSA平均降低了14.8%(p = 0.005,n = 18)。家长报告说,这种沐浴露比传统的漂白浴使用起来明显更容易(p < 0.001)。使用这种配方后临床疾病严重程度评分的显著降低令人鼓舞。