Wet dressing therapy in conjunction with topical corticosteroids is effective for rapid control of severe pediatric atopic dermatitis: Experience with 218 patients over 30 years at Mayo Clinic
Wet dressing therapy in conjunction with topical corticosteroids is effective for rapid control of severe pediatric atopic dermatitis: Experience with 218 patients over 30 years at Mayo Clinic
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DOI：
10.1016/j.jaad.2011.06.025
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发表时间：
2012-07-01
影响因子：
13.8
通讯作者：
Davis, Mark D. P.
中科院分区：
文献类型：
--
作者：
Dabade, Tushar S.;Davis, Dawn M. R.;Davis, Mark D. P.
背景资料：在我们的机构，住院接受强化治疗（结合湿敷料和局部皮质类固醇）是严重儿童特应性皮炎的主要干预措施。目的：我们试图回顾湿敷料治疗儿童特应性皮炎的疗效。方法：我们回顾了从1980年1月1日至2010年4月20日住院的儿童患者的记录，这些患者接受了特应性皮炎的强化局部治疗。结果：总共有218名儿童患者患有严重到足以住院的广泛性特应性皮炎，尽管先前进行了门诊局部治疗和其他干预，如免疫调节剂，光疗，饮食控制，或避免接触过敏原。平均（SD）年龄为5.97（4.91）岁（范围：2个月-17岁）; 141例患者（65%）为女性。有266例住院：192例患者（72%）有一次住院，15例（6%）有两次住院，11例（4%）有3次或3次以上住院。平均（SD）住院时间为3.61（2.23）天（范围：1-16天）。出院时，所有患者均表现出改善。在266例住院治疗中，有239例患者的病历显示了量化的改善（总体评估）：121例（45%）改善75%至100%，102例（38%）改善50%至75%，16例（6%）改善25%至50%。局限性：这是一项回顾性研究。强化住院治疗（湿敷料和局部皮质类固醇）是非常有效的控制严重和顽固性特应性皮炎。强化局部治疗，虽然未充分使用，是一个有效的第一线的方法，严重特应性皮炎患者。（J Am Acad Dermatol 2012;67：100-6.）
Background: At our institution, hospitalization for intensive treatment (combining wet dressings and topical corticosteroids) is a primary intervention for severe pediatric atopic dermatitis. Prior reports of this treatment are limited.Objective: We sought to review the efficacy of wet dressings for pediatric atopic dermatitis.Methods: We reviewed records of pediatric patients hospitalized from January 1, 1980, through April 20, 2010, who received intensive topical treatments for atopic dermatitis.Results: In total, 218 pediatric patients had widespread atopic dermatitis severe enough to warrant hospitalization, despite prior outpatient topical treatments and other interventions such as immunomodulating agents, phototherapy, dietary manipulation, or contact allergen avoidance. Mean (SD) age was 5.97 (4.91) years (range, 2 months-17 years); 141 patients (65%) were female. There were 266 hospitalizations: 192 patients (72%) had one admission, 15 (6%) had two admissions, and 11 (4%) had 3 or more admissions. Mean (SD) duration of hospitalization was 3.61 (2.23) days (range, 1-16 days). Upon discharge, all patients showed improvement. In 239 of 266 hospitalizations, patient records showed quantification of improvement (global assessment): 121 (45%) had 75% to 100% improvement, 102 (38%) had 50% to 75% improvement, and 16 (6%) had 25% to 50% improvement.Limitations: This was a retrospective study.Conclusion: Intensive inpatient treatment (with wet dressings and topical corticosteroids) was highly effective in controlling severe and recalcitrant atopic dermatitis. Intensive topical treatment, although underused, is an effective first-line approach for patients with severe atopic dermatitis. (J Am Acad Dermatol 2012;67:100-6.)