Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
Volume 2, Issue 4, Pages 400-406Publisher
ELSEVIER
DOI: 10.1016/j.jaip.2014.04.009
Keywords
Wet wrap therapy; Atopic dermatitis; Management; Outcomes
Categories
Funding
- ADP at National Jewish Health
- outcome research in the pediatric care unit
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BACKGROUND: Atopic dermatitis (AD) is the most common chronic, relapsing inflammatory skin disease of children and is a global public health problem. National and international AD guidelines address AD care in a stepwise fashion. Wet wrap therapy (WWT) is a therapeutic intervention for moderate-to-severe AD. OBJECTIVE: This cohort study evaluated the effectiveness of WWT as part of a multidisciplinary AD treatment program to improve disease severity. Patients treated in this unique outpatient program had moderate-to-severe AD and had multiple therapies that failed. METHODS: An observational cohort study was completed. The primary outcome was improvement in AD severity as measured by SCORAD (Scoring Atopic Dermatitis). Demographics; clinical management of AD, including use of antibiotics and systemic treatments; and WWT methodology were comprehensively described. RESULTS: Seventy-two children with a mean +/- SD age of 4.6 +/- 3.12 years were included. By using a paired t test, the SCORAD at admission and at discharge showed significant differences in mean -SD values, of 49.68 +/- 17.72 versus 14.83 +/- 7.45, respectively (t, 18.93; df, 71; P < .001). None of these patients required systemic immunosuppressive therapy during the treatment program. By using a previously published parent-administered outcomes tool, patients were shown to maintain clinical improvement of their AD 1 month after discharge. CONCLUSION: To our knowledge, this study is the largest to date of WWT for pediatric patients with moderate-to-severe AD by using a validated outcomes tool. None of the patients required systemic immunosuppressive therapy, and only 31% were treated with an oral antibiotic. This study demonstrated the benefit of incorporating WWT as an acute intervention in a supervised multidisciplinary AD treatment program with lasting benefit 1 month after discontinuing this intervention. (C) 2014 American Academy of Allergy, Asthma & Immunology
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