Treatment of refractory atopic dermatitis using 'wet-wrap' dressings and diluted corticosteroids: results of standardized treatment in both children and adults.
BACKGROUND
'Wet-wrap' dressings with diluted corticosteroids form an alternative treatment in patients with refractory atopic dermatitis (AD).


OBJECTIVE
To evaluate a standardized treatment, using wet-wrap dressings with diluted corticosteroids, in patients with refractory AD.


METHODS
Results of treatment, complications and possible side effects were retrospectively evaluated in 14 children and 12 adults.


RESULTS
Skin lesions improved dramatically during 1 week of inpatient treatment. A significant decrease in early-morning serum cortisol levels was measured. Levels below the normal range were only observed after 1 week in 2 adults and on day 4 in 3 children. Suppression of the hypothalamus-pituitary-adrenal-cortex axis in 1 adult and a new exacerbation of AD in 2 children and 3 adults complicated long-term treatment at home. Additional complications included folliculitis, a Pseudomonas aeruginosa infection, a secondary bacterial infection and refractory skin lesions between bandages.


CONCLUSIONS
Wet-wrap dressings and diluted corticosteroids form an effective treatment in patients with refractory AD.
Devillers
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AC
Department of Dermatology and Venereology, University Hospital Rotterdam, The Netherlands. devillers@derd.azr.nl
de Waard-van der Spek
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FB
Mulder
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Oranje
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AP
D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D001458:Bandages / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones