Yale University School of Medicine, New Haven, Connecticut.
Department of Dermatology and Pediatrics, New Haven, Connecticut; Yale University School of Medicine, New Haven, Connecticut.
J Am Acad Dermatol. 2016 Aug;75(2):306-11. doi: 10.1016/j.jaad.2016.04.060. Epub 2016 Jun 1.
Soak and smear (SS), a technique whereby a bath is followed by topical corticosteroid (TCS) application to wet skin, is reported to be a beneficial adjunctive therapy for patients with recalcitrant atopic dermatitis (AD).
We evaluated whether SS is of greater benefit than application of TCS to dry skin for the treatment of childhood AD.
A randomized, investigator-blinded, controlled study was performed in children with AD. Patients were randomized to apply TCS either via SS (n = 22) or to dry skin (n = 23) for 14 days. The primary outcome was an improvement in the Eczema Area and Severity Index score. Secondary outcomes included assessments of disease burden, pruritus, and sleep; morning cortisol levels; and adverse effects.
Patients with AD severity who applied TCS via SS or to dry skin improved 84.8% (95% confidence interval 77.5-92.1) and 81.4% (95% confidence interval 70.3-92.4) by Eczema Area and Severity Index score, respectively. There was no statistical difference between the 2 groups (P value = .85).
Small sample size limited the power of our study.
We did not find that application of TCS to presoaked skin works better than application to dry skin for the treatment of AD in children.
浸泡涂抹（SS）是一种在沐浴后局部使用皮质类固醇（TCS）涂抹于湿润皮肤的辅助治疗方法，据称对治疗难治性特应性皮炎（AD）患者有益。
我们评估了 SS 相较于 TCS 涂于干燥皮肤对儿童 AD 治疗的益处。
对 AD 患儿进行了一项随机、研究者设盲、对照研究。患者被随机分为两组，分别通过 SS（n=22）或干燥皮肤（n=23）涂抹 TCS 治疗 14 天。主要结局是改善湿疹面积和严重程度指数评分。次要结局包括疾病负担、瘙痒和睡眠评估；清晨皮质醇水平；以及不良反应。
AD 严重程度患者通过 SS 或干燥皮肤涂抹 TCS 后分别改善了 84.8%（95%置信区间 77.5-92.1）和 81.4%（95%置信区间 70.3-92.4）。两组间无统计学差异（P 值=0.85）。
样本量小限制了本研究的效力。
我们没有发现 TCS 涂于预浸泡皮肤比涂于干燥皮肤治疗儿童 AD 效果更好。
