The use of combination treatments falls within the standard of care for psoriasis, even if these combinations have not been extensively studied in clinical trials.

Background: Analyzing adherence to treatment and outcomes in atopic dermatitis is limited by methods to assess continual disease severity. Atopic dermatitis significantly impacts sleep quality, and monitoring sleep tbrougb actigrapby may capture disease burden.Purpose: To assess if actigrapby monitors provide continuous measures of atopic dermatitis disease severity and to preliminarily evaluate tbe Impact of a sbort-course, bigb-potency topical corticosteroid regimen on sleep quality.Methods: Ten patients witb mild to moderate atopic dermatitis applied topical fluocinonide 0.1% cream twice daily for 5 days. Sleep data were captured over 14 days using wrist actigrapby monitors. Investigator Global Assessment (IGA) and secondary measures of disease severity were recorded. Cbanges in quantity of in-bed time sleep were estimated witb random effects models.Results: Tbe mean daily ¡n-bed time, total sleep time, and wake after sleep onset (WASO) were 543.7 minutes (SEM 9.4), 466.0 minutes (SEM 7.7), and 75.0 minutes (SEM 3.4), respectively. WASO, a marker of disrupted sleep, correlated witb baseline (p = .75) and end of treatment IGA (p = .70). Most patients did not bave marked cbanges in sleep. IGA scores declined by a median cbange of 1 point at days 7 (p = .02) and 14 (p = .008).Conclusions: Using actigrapby, atopic dermatitis disease severity positively correlated witb sleep disturbances. Actigrapby monitors were well tolerated by tbis cobort of atopic dermatitis subjects.Contexte: Les moyens d'évaluation continue du degré de gravité de la dermatite atopique ne permettent pas de bien analyser le respect du traitement et les résultats cliniques. La dermatite atopique altère passablement la qualité du sommeil, et la surveillance du sommeil à l'aide de l'actimétrie peut permettre d'estimer la gravité de la maladie.Buts: L'étude avait pour buts de vérifier si l'actimétrie pourrait fournir des mesures continues du degré de gravité de la dermatite atopique et d'évaluer, de manière exploratoire, l'effet de la corticotbérapie topique administrée à forte dose mais sur une courte période, sur la qualité du sommeil.Méthode: Dix sujets souffrant de dermatite atopique légère ou modérée ont appliqué du fluocinonide topique en crème, à 0.

Actigraphy wristband monitoring can be used to continuously assess disease severity in children with atopic dermatitis.

Background: Adherence in the treatment of chronic inflammatory skin diseases such as atopic dermatitis is poor. Methods to improve adherence have proven difficult.Purpose: To determine whether a short course of treatment with a high-potency corticosteroid will improve adherence compared to longer treatment studies and if improvement in disease and itch continues after treatment. Methods: 10 patients with mild to moderate atopic dermatitis were instructed to apply fluocinonide 0.1% cream twice daily for 5 days. Adherence was self-reported and electronically monitored. Treatment outcomes were assessed in terms of Visual Analog Scale of Itch (VAS), Eczema Area and Severity Index (EASI), and Investigator Global Assessment (IGA) scores.Results: The median adherence rate was 40% (range of 0-100). The median percent change in VAS from baseline measures on days 7 and 14 were 90% (range -13, 100, p=0.02) and 52% (range 0, 100, p=0.004). On days 7 and 14, 20% and 70% patients achieved an EASI-75 and 40% and 60% an IGA of 0 or 1.Limitations: Small sample size limited subgroup analyses. Conclusions: Adherence rates with short-term treatment were similar to previously reported rates in longer term treatment studies. However, even non-adherent patients had significant improvement in itch and disease severity.

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