Wet-wrap therapy with halometasone cream for severe adult atopic dermatitis.

BACKGROUND

Currently there is no cure for severe atopic dermatitis (AD). Wet-wrap therapy (WWT) has also been used to treat pediatric AD and shown a satisfactory effectiveness, but clinical evidence supporting the use of WWT on severe adult AD is still insufficient.

METHODS

Twelve patients (eight men and four women) with severe AD (SCORing Atopic Dermatitis [SCORAD] score ≥ 50) treated between January 2015 and September 2017 in our hospital were included. The patients underwent WWT (daily dose: 15 g halometasone cream+100g Vaseline ointment) twice daily for 2 h/session for 7 days. SCORAD, visual analog scale (VAS) for pruritus, investigator's global assessment (IGA), dermatology life quality index (DLQI) scores and serum cortisol levels were determined before and after the WWT.

RESULTS

The patients (mean age: 58.9 ± 18.9 years; range: 27-85 years) had a median disease duration of 27.5 months. After the WWT, the average scores of SCORAD (28.79 ± 5.16 vs. 68.59 ± 8.61, 95%CI: 35.18-44.42), VAS (2.75 ± 0.62 vs. 7.5 ± 1.17, 95%CI: 4.14-5.36), IGA (1.83 ± 0.39 vs. 4.08 ± 0.51, 95%CI: 1.96-2.54), and DQLI score (8.33 ± 1.83 vs. 13.83 ± 2.79, 95%CI: 4.16-6.84) reduced significantly compared with the scores before the WWT (All P < 0.001). However, serum cortisol levels were not affected significantly by the WWT. Four patients complained of tolerable wet dressing-associated discomforts, which was resolved after the wet dressing was removed when the WWT was completed. For the 85-year-old man, serum cortisol levels were lower than the normal value after the WWT (3.67 μg/dL) but restored to the normal levels (13.44 μg/dL) 2 weeks after the WWT was ended. No other adverse events occurred.

CONCLUSION

WWT can relieve pruritus, reduce skin lesions, and improve quality of life in adult patients with severe AD. Thus, WWT may be effective and safe for severe adult AD. Trial registration No. is ChiCTR1800014909 ( http://www.chictr.org.cn/index.aspx ).