Efficacy and patient opinion of wet‐wrap dressings using 0.1% triamcinolone acetonide ointment vs cream in the treatment of pediatric atopic dermatitis: A randomized split‐body control study

Abstract

Background: Wet wraps can be an effective means of improving atopic dermatitis (AD). Little research has been done regarding the comparative efficacy of topical steroid vehicles and patient preference.Objective: This study aimed to compare the efficacy of 0.1% triamcinolone acetonide ointment vs cream used with wet wraps in pediatric patients with AD and to explore patient preference/opinion. Methods:We performed a small, randomized, investigator-blind prospective study of 39 pediatric patients experiencing symmetric, bilateral AD flares. Patients were instructed to apply a topical steroid cream to one extremity and apply the same topical steroid in an ointment vehicle to the other extremity using the wet-wrap technique once or twice daily for 3 to 5 consecutive days. Patients were evaluated at a followup visit.Results: Comparison of the change in Investigator's Global Assessment scores disclosed no significant difference between efficacy ratings of cream (mean difference = 0.72) and ointment (mean difference = 0.59) when used with wet wraps (P = 0.22). Although patients found the ointment more difficult to apply, they were more likely to prefer ointments for future prescriptions (P < 0.01). Conclusion: Patient preference of corticosteroid vehicle is what should ultimately drive treatment. In this small study, we found no difference in efficacy between triamcinolone acetonide wet wraps with cream vs ointment. Dermatologists should select the vehicle of the patient's choice as it may increase satisfaction with treatment. K E Y W O R D S atopic dermatitis, pediatrics, topical corticosteroid, wet wraps Pediatric Dermatology CADMUS et Al.

Tacrolimus 0.03% ointment treatment in exfoliative cheilitis: A randomised controlled clinical trial and monitoring blood concentration

“…Different vehicles may have differences in some ways, such as the release, absorption and activity of the active ingredients 17 . However, these differences are considered irrelevant, based on some previous studies reporting that different vehicles had no effect on skin diseases such as atopic dermatitis and psoriasis 18 . According to the current research results and upon carefully examining the components of those vehicles, we speculated that differences between ointment and cream might have no effect on EC.…”

Pediatric Atopic Dermatitis: Update on the Treatment Options

“…No differences have been noticed between the two methods, but patients related that they felt better with the dressings technique and they would prefer this kind of treatment in the future. (23) A potential treatment option for severe AD could be use of Omalizumab (systemic administration-injection), an anti-IgE antibody. By binding to the IgE, it limits mast cell degranulation therefore decreasing release of inflammatory mediators.…”

Narrative review on the management of moderate-severe atopic dermatitis in pediatric age of the Italian Society of Pediatric Allergology and Immunology (SIAIP), of the Italian Society of Pediatric Dermatology (SIDerP) and of the Italian Society of Pediatrics (SIP)

“…The TCSs most suitable for WWT are fluticasone propionate, methylprednisolone aceponate, mometasone furoate, hydrocortisone acetate and prednicarbate. TCSs are to be combined with an emollient with a hydrophilic base at a dilution of 10% (1 part of steroid and 9 parts of emollient) or 5% when treating the face [ 110 – 112 ]. Latex-free and washable viscose elastic bandages can also be used, which can be applied for 3-24 hours, although daytime bandages are always preferred despite the difficulty in being accepted by children.…”