Rakita Uros, Kaundinya Trisha, Silverberg Jonathan I
From the *Department of Internal Medicine, Montgomery Campus of the University of Alabama Heersink School of Medicine, Montgomery, Alabama, USA.
Department of Dermatology, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA.
Dermatitis. 2023 Sep-Oct;34(5):425-431. doi: 10.1089/derm.2022.29020.jis. Epub 2023 Jan 19.
Evidence-based recommendations for optimal showering/bathing practices are lacking for atopic dermatitis (AD) patients. To determine longitudinal associations between showering/bathing practices and AD severity in AD patients. A prospective single-center dermatology practice-based study was performed. Shower/bath frequency and duration, and frequency of applying moisturizers after showering/bathing were evaluated. AD severity was assessed using objective component of Scoring Atopic Dermatitis (o-SCORAD), SCORAD-itch, Eczema Area and Severity Index (EASI), Patient-Oriented Eczema Measure (POEM), and Dermatology Life Quality Index (DLQI). Repeated-measures regression models examined associations of showering/bathing and moisturizing practices with change in AD severity measures over time. Showering/bathing more than daily versus once daily was associated with higher SCORAD-itch, o-SCORAD, EASI, POEM, and DLQI scores; less than daily versus once daily showering/bathing was not associated with any outcomes. Consistent and even inconsistent application of moisturizer after showering/bathing was associated with lower o-SCORAD, EASI, and POEM scores. Showering/bathing duration was not associated with AD outcomes. Severe SCORAD-sleep, o-SCORAD, EASI, and POEM were associated with less adherence to all showering/bathing recommendations. Showering/bathing daily or less frequently and applying moisturizer postshower/bath were associated with lower AD severity; showering/bathing duration was not. Recommendations concerning shower durations may not be necessary when counseling AD patients.
目前缺乏针对特应性皮炎（AD）患者最佳淋浴/沐浴方式的循证建议。为了确定AD患者的淋浴/沐浴方式与AD严重程度之间的纵向关联。开展了一项基于单中心皮肤科实践的前瞻性研究。评估了淋浴/沐浴频率、时长以及淋浴/沐浴后涂抹保湿剂的频率。使用特应性皮炎评分（o-SCORAD）的客观部分、SCORAD瘙痒评分、湿疹面积和严重程度指数（EASI）、患者导向性湿疹评估（POEM）以及皮肤病生活质量指数（DLQI）来评估AD的严重程度。重复测量回归模型检验了淋浴/沐浴及保湿方式与AD严重程度指标随时间变化之间的关联。与每天淋浴/沐浴一次以上相比，每天淋浴/沐浴一次与更高的SCORAD瘙痒评分、o-SCORAD评分、EASI评分、POEM评分和DLQI评分相关；与每天淋浴/沐浴一次相比，每天淋浴/沐浴次数少于一次与任何结果均无关联。淋浴/沐浴后持续且一致或不一致地涂抹保湿剂与较低的o-SCORAD评分、EASI评分和POEM评分相关。淋浴/沐浴时长与AD结局无关。严重的SCORAD睡眠评分、o-SCORAD评分、EASI评分和POEM评分与对所有淋浴/沐浴建议的依从性较低相关。每天或更不频繁地淋浴/沐浴以及淋浴/沐浴后涂抹保湿剂与较低的AD严重程度相关；淋浴/沐浴时长则不然。在为AD患者提供咨询时，可能无需给出关于淋浴时长的建议。
