title: Novel sodium hypochlorite cleanser shows clinical response and excellent acceptability in the treatment of atopic dermatitis.
abstract: The intermittent use of dilute sodium hypochlorite "bleach baths" has shown efficacy as adjunctive therapy for atopic dermatitis (AD). This feasibility study evaluated the clinical response and patient acceptability of treatment with a cleansing body wash containing sodium hypochlorite in children with AD. This was a 12-week open-label feasibility study of 18 children with AD conducted in a pediatric dermatology outpatient clinic between May 2011 and July 2012. Children with moderate to severe AD, defined as an Investigator Global Assessment (IGA) score of at least 3 on a 5-point scale, who were age 6 months and older and had lesional cultures positive for Staphylococcus aureus at baseline were included. Patients were instructed to wash 3 days/week for 12 weeks with the sodium hypochlorite-containing cleansing body wash. During the study period, patient's individualized topical and systemic treatment regimens were continued. Clinical response to treatment was measured using an IGA score and the percentage of body surface area (BSA) affected. Parents were also administered a retrospective questionnaire evaluating acceptability of the product. There was a statistically significant reduction in IGA score at all time points, with an overall mean reduction from baseline to final measurement using the last observation carried forward in all patients of 1.0 (p = 0.001, n = 18). Similarly the mean reduction of BSA affected was 14.8% (p = 0.005, n = 18). Parents reported that the body wash was significantly easier to use than traditional bleach baths (p < 0.001). The significant reductions in clinical disease severity scores with use of this formulation are encouraging.
authors.affiliation: Department of Dermatology, Baylor University Medical Center, Dallas, TX 75246, USA. Caitriona.ryan@baylorhealth.edu
authors.forename: Caitriona
authors.initials: C
authors.lastname: Ryan
authors.forename: Richard E
authors.initials: RE
authors.lastname: Shaw
authors.forename: Clay J
authors.initials: CJ
authors.lastname: Cockerell
authors.forename: Shari
authors.initials: S
authors.lastname: Hand
authors.forename: Fred E
authors.initials: FE
authors.lastname: Ghali
mesh_terms: D000287:Administration, Topical; D001494:Baths / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000382:microbiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D016877:Oxidants / Q000008:administration & dosage*; D010865:Pilot Projects; D011446:Prospective Studies; D012189:Retrospective Studies; D012973:Sodium Hypochlorite / Q000008:administration & dosage*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D016877:Oxidants; D012973:Sodium Hypochlorite