Ainley-Walker P F, Patel L, David T J
Department of Child Health, University of Manchester, UK.
Arch Dis Child. 1998 Aug;79(2):149-52. doi: 10.1136/adc.79.2.149.
To document and evaluate the outcome of side to side comparisons of different corticosteroids in determining the most effective topical treatment for individuals admitted to hospital for control of atopic dermatitis.
Retrospective case note study of 82 admissions (66 children) to a children's hospital for treatment of atopic dermatitis between 1 June 1993 and 31 October 1995. Different topical corticosteroid ointments were applied to the two sides of the body. The outcome measure was a comparison between the two sides, to see whether one treatment was better than the other.
More potent topical corticosteroid preparations appeared more effective than weaker preparations on 25 occasions, there was no difference on 20 occasions, and on seven occasions a weaker preparation appeared more effective. Incorporation of an antimicrobial agent did not appear to increase the efficacy of a preparation.
The management of atopic dermatitis is bedevilled by considerable spontaneous fluctuations in severity, leading to uncertainty as to whether a new treatment is beneficial; a coincidental flare up of the skin lesions may be wrongly attributed to a particular treatment, which is then discarded. Comparing different topical treatments simultaneously on opposite sides of the body is a feasible and rational way to determine the optimum treatment for an individual with atopic dermatitis.
记录并评估不同皮质类固醇药物进行双侧比较的结果，以确定对因控制特应性皮炎而入院的个体最有效的局部治疗方法。
对1993年6月1日至1995年10月31日期间因治疗特应性皮炎入住一家儿童医院的82例患者（66名儿童）进行回顾性病例记录研究。在身体两侧涂抹不同的局部皮质类固醇药膏。结果测量指标是两侧之间的比较，以观察一种治疗方法是否优于另一种。
在25例中，更强效的局部皮质类固醇制剂似乎比较弱的制剂更有效；在20例中没有差异；在7例中，较弱的制剂似乎更有效。加入抗菌剂似乎并未提高制剂的疗效。
特应性皮炎的治疗因病情严重程度存在相当大的自发波动而受到困扰，这导致难以确定新治疗方法是否有益；皮肤病变的巧合性发作可能被错误地归因于某种特定治疗方法，然后该方法被摒弃。在身体的相对两侧同时比较不同的局部治疗方法，是确定特应性皮炎个体最佳治疗方法的一种可行且合理的方式。
