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

ABSTRACT

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).

KEYWORDS:

• Atopic dermatitis
• effectiveness
• halometasone cream
• serum cortisol
• wet-wrap therapy

Acknowledgments

None reported.

Declaration of interest

The authors have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article. A Postgraduate Medicine peer reviewer declare that they are an investigator, speaker and/or advisory board member for Abbvie, Amgen, Boehringer Ingelheim, Celgene, Dermira, GSK, Galderma, Janssen, Kyowa Kirin, Medimmune, Novartis, Pfizer, Sanofi Genzyme, Regeneron, Roche, UCB, Valeant. All other Postgraduate Medicine peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.