title: Pseudoceramide for childhood eczema: does it work?
abstract: OBJECTIVE
  Atopic eczema is a chronic relapsing skin disease associated with atopy, and characterised by reduced skin hydration, impaired skin integrity (transepidermal water loss), and poor quality of life. Proper emollient usage is an important facet of its management. This study aimed to establish an approach to evaluate the efficacy of using an emollient over a 4-week period.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A paediatric dermatology out-patient clinic of a university teaching hospital in Hong Kong.
  
  
  METHODS
  Consecutive new patients aged 5 to 18 years with atopic eczema diagnosed according to Hanifin and Rajka's criteria were recruited from March to August 2009. They or their parents were instructed to liberally apply the test emollient to the flexures and areas affected with eczema, twice daily. Outcome assessments were repeated 2 and 4 weeks later.
  
  
  METHODS
  Skin hydration and transepidermal water loss in the right forearm (2 cm below antecubital flexure), and disease severity (SCORing Atopic Dermatitis index) and Children's Dermatology Life Quality Index. At the end of the study period, a global assessment of treatment was recorded.
  
  
  RESULTS
  Thirty-three patients with atopic eczema were recruited and treated with applications of a pseudoceramide-containing cream (Curel, Kao, Japan). The mean age of the patients (16 males and 17 females) was 12 (standard deviation, 4) years. Four weeks following the use of the cream, skin hydration improved significantly and fewer patients were using topical corticosteroids. In these patients, there was no deterioration in transepidermal water loss, eczema severity, or quality of life.
  
  
  CONCLUSIONS
  The pseudoceramide cream improved skin hydration but not severity or quality of life over a 4-week usage.
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. ehon@hotmail.com
authors.forename: K L
authors.initials: KL
authors.lastname: Hon
authors.forename: Susan S
authors.initials: SS
authors.lastname: Wang
authors.forename: Zoe
authors.initials: Z
authors.lastname: Lau
authors.forename: H C
authors.initials: HC
authors.lastname: Lee
authors.forename: Kenneth K C
authors.initials: KK
authors.lastname: Lee
authors.forename: T F
authors.initials: TF
authors.lastname: Leung
authors.forename: N M
authors.initials: NM
authors.lastname: Luk
mesh_terms: D000293:Adolescent; D002518:Ceramides / Q000627:therapeutic use*; D002648:Child; D004485:Eczema / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology; D004643:Emollients / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012867:Skin / Q000378:metabolism
chemical_list: D002518:Ceramides; D004643:Emollients