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J Allergy Clin Immunol Pract. 2014 Jul-Aug;2(4):400-6. doi: 10.1016/j.jaip.2014.04.009.

Wet wrap therapy in children with moderate to severe atopic dermatitis in a multidisciplinary treatment program.

Author information

1
College of Nursing, University of Colorado, Aurora, Colo; Department of Nursing, Children's Hospital Colorado, Aurora, Colo. Electronic address: Noreen.nicol@ucdenver.edu.
2
Department of Pediatrics, National Jewish Health, Denver, Colo.
3
Department of Biostatistics, National Jewish Health, Denver, Colo.

Abstract

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.

KEYWORDS:

Atopic dermatitis; Management; Outcomes; Wet wrap therapy

PMID:
25017527
DOI:
10.1016/j.jaip.2014.04.009
[Indexed for MEDLINE]

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