The Clinical Efficacy and Safety of Moisturizing Emollients in the Treatment of Atopic Dermatitis
|School||Chongqing Medical University|
|Keywords||atopic dermatitis emollients epidermal barrier children|
BackgroundAtopic dermatitis (atopic dermatitis, AD) is a chronic, recurrent skindisease, with dry skin, pruritis and inflammation is the main features. Thepathogenesis of AD have not been entirely elucidated. It may be associatedwith genetic factors, environmental factors, immunologic factors and so on.The study found, abnormal skin barrier structure and function may be theprimary mechanism of atopic dermatitis onset in rencent years. AD has avariety of clinical manifestations, erythema, papule, exudation, scales andlichenification. About80%of the AD patients have varying degrees of dryskin disease, manifested as skin dryness and desquamation, particularly inthe winter season, AD lesions are often aggravated this season. Therefore,treatments of AD must be directed to relieve the dryness and control theitching and restore the epidermal barrier. Therefore, restoring skin barrierfunction, relieving dry skin and itching are the treatments of AD recurrenceof important measures. External using of moisturizing emollients as basictreatment measures had became the consensus of AD treatment. At present, foreign studies have shown that topical corticosteroids combined withmoisturizing emollients can effectively reduce the recurrence of AD andprolong the remission stage. This study adopts randomized, parallel-groupcomparison method to explore the efficacy of single topical corticosteroidsand topical corticosteroids combined with emollients in the treatment ofAD, and evaluate its safety.ObjectiveTo evaluate the clinical efficacy and safety of moisturizing emollientsin adjuvant treatment of mild to moderate atopic dermatitis in children and rthe decreasing risk of relapse of recurrent AD.MethodsA randomized, parallel controlled experiment. The study included30cases of aged2~12meets Hanifin-Rajka standards for mild to moderate ADpatients, male14cases, female16cases, average age is4.95±2.80years old.All were randomly divided into test group and control guoup. The test groupwas given topical corticosteroids combined with moisturizing emollients fortreatment, the control group treated only by external application of topicalcorticosteroids therapy. All the patients carried out follow-ups on day0,14,28and56. The SCORAD, erythema, papula/edema, exudation/crust,excoriation/scratch, lichenification, skin dryness, pruritus and sleepdisorders were all assessed by investigators and patients. Comparing each item scores between test group and control group.ResultsAll30cases completed the study.1.SCORAD: no significant difference between the test group and thecontrol group of disease severity, SCORAD value on day0（39.4±7.781、38.0±9.016，P＞0.05）, also no significant difference on day14and28. Buton day56test group SCORAD was significantly lower than the controlgroup (3.933±5.885、12.133±9.855，P＜0.05).2.Effective rates and recurrence rates: The effective rates on day28and56higher than the control group（on day28：100%、66.7%，P＜0.05；on day56：93.3%、53.3%，P＜0.05）, but no significant difference on day14（66.7%、46.7%，P＞0.05）. The recurrence rates on day56lower thanthe control group（6.6%、46.7%，P＜0.05）.3.Objective signs：There were no significant difference in objectivesymptom score between the test group and the control group on day0(P＞0.05). The scores of erythema in the test group were significantly lowerthan the control group on day56(0.13±0.352、0.53±0.640，P＜0.05), and thescores of skin dryness on day28and56also significantly lower than thecontrol group（on day28：0.133±0.352、0.6±0.507，P＜0.05； on day56：0.067±0.258、0.467±0.518，P＜0.05）. Throughout the follow-up process,the scores of papula/edema, exudation/crust, excoriation/scratch andlichenification in the test group and the control group had no significantly diffierence(P＞0.05).4.Subjective symptoms：The scores of pruritus and sleep disorder onday0had no significantly difference between The test group and the controlgroup(P＞0.05), the scores of pruritus in the test group on day56weresignificantly lower than the control group（1.333±1.447、2.533±1.685， P＜0.05）, Throughout the follow-up process, the scores of sleep disorderhad no significantly diffierence between the test group and the controlgroup（P＞0.05）.5. No adverse reaction occurred during the entire experiment.ConclusionTopical corticosteroids added to moisturizing emollients for treatmentof mild to moderate atopic dermatitis children can improve the effectiverates. Long-term regular use moisturizing emollients can relieve the skin’serythema, dryness and pruritus, also significantly reduce the risk of relapse.