Instant barrier repair: a pilot study investigating occlusion with a new hydrogel patch for the treatment of atopic dermatitis

Park, Kelly K; Kamangar, Faranak; Heller, Misha M.; Lee, Eric; Bhutani, Tina; Busse, Kristine; Patel, Tejas; Koo, John

doi:10.3109/09546634.2011.594871

Cited by 4 publications

(8 citation statements)

References 3 publications

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“…A typical child will require 150-200 g of emollient on a weekly basis, and adults may require up to 500 g. Emollients containing potential allergens such as peanut, oat, and shea nut should be avoided since the skin can serve as entry for allergic sensitization [ 46 ]. A recent pilot study of 15 AD patients using a hydrogel compound under occlusion demonstrated similar efficacy to use of triamcinolone 0.1 %, supporting the concept that restoration of barrier function is an imperative treatment objective [ 49 ].…”

Section: Treatmentsmentioning

confidence: 96%

Filaggrin Mutations and the Atopic March

Heimall

Spergel

2014

Filaggrin

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Atopic disease is increasing in prevalence throughout the world, affecting up to 20 % of individuals, particularly those in industrialized nations [ 1 ]. The fi rst manifestation of atopic disease is often atopic dermatitis (AD), which is the most common chronic cutaneous infl ammatory disease of early childhood. AD affects approximately 15-20 % of children worldwide, with signifi cant impairment of quality of life attributable to the associated symptoms and secondary infections [ 2 ]. In the United States, it is estimated that 17 % of children aged 5-9 years suffer from AD. This disorder is also considered the fi rst step of the atopic march, which is the hypothesis that atopic disease occurs as a progression of symptoms with age. In the atopic march, AD is associated with later development of allergic rhinitis, food allergy, and allergic asthma. While food allergy also commonly presents early in life, allergic rhinitis and allergic asthma with aeroallergen sensitization are more commonly seen in later childhood. By the end of the fi rst 6 years of life, 75 % of children with AD go on to develop allergic rhinitis, while 50 % go on to develop asthma [ 3 ]. FilaggrinFilaggrin is a S100 calcium-binding protein with key roles in establishing the skin's epidermal barrier function. It is expressed in the skin and in the

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Section: Treatmentsmentioning

confidence: 96%

Filaggrin Mutations and the Atopic March

Heimall

Spergel

2014

Filaggrin

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“…In a pilot study of 15 patients, Park et al (2011) evaluated the efficacy and safety of a hydrogel patch for AD treatment. The hydrogel patch used in this study was composed of an adhesive, thin, flexible, hydrogel layer on an impermeable urethane surface.…”

Section: Hydrogel Patchmentioning

confidence: 99%

“…This study appears to demonstrate that instant correction of the dysfunctional skin barrier with the hydrogel patch can improve signs and symptoms of AD comparable to TAC 0.1% cream. Thus, the hydrogel patch may provide a new approach to occlusive therapy without the potential risks of topical corticosteroid use (Park et al 2011) 3.4 Cutaneous and systemic side effects Topical corticosteroid use can cause both cutaneous and systemic side effects, most significantly laboratory adrenal insufficiency. Risk factors include the use of high potency corticosteroids, occlusive or prolonged therapy, and application to thin-or barriercompromised skin lesions.…”

Section: Hydrogel Patchmentioning

confidence: 99%

“…(Haigh and Smith 1991;Gao and Li Wan Po 1994;Ohtani et al 2002;Kizu et al 2004) Furthermore, the application of a hydrogel patch, which appeared to have similar efficacy as topical corticosteroid use, may potentially serve as an ideal method of treating AD while avoiding topical corticosteroids. (Park et al 2011) But, additional studies on the efficacy of the hydrogel patch in the treatment of AD are needed. Ultimately, if prolonged topical corticosteroid use is required in certain patients with refractory disease, adrenal function may be monitored using morning plasma cortisol and urinary steroid levels, in combination with rapid ACTH stimulation testing, while evaluating the patient for cutaneous atrophy or Cushingoid features (Levin and Maibach 2002).…”

Section: Occlusion In Clinical Practicementioning

confidence: 99%

“…The hydrogel patch, therefore, offers an innovative approach to complete barrier repair. (Park et al 2011) Regardless of the treatment approach, occlusive therapy offers many advantageous such as a cooling effect on inflamed skin, increased penetration of topical agents, enhanced skin hydration, and a barrier to external antigens and trauma (i.e. scratching).…”

Section: Introductionmentioning

confidence: 99%

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Occlusive Therapy in Atopic Dermatitis

Heller¹,

Lee²,

Kamangar³

et al. 2012

Atopic Dermatitis - Disease Etiology and Clinical Management

Self Cite

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Atopic Dermatitis-Disease Etiology and Clinical Management 270 promote skin dryness if too little topicals are applied. (Nicol 1987; Goodyear et al. 1991; Bridgman 1995; Krakowski et al. 2008) Occlusion alone of both normal and lesional eczematous skin can result in increased density of cutaneous microbial flora. (Aly et al. 1978; Rajka et al. 1981) Moreover, there is a positive association between Staphylococcus aureus (S. aureus) colonization and disease severity. (Williams 2000) These findings suggest that occlusion, by increasing the density of S. aureus, might push already colonized eczematous skin into the realm of clinical infection. In addition, innate production of cutaneous anti-microbial peptides, such as sphingosine and -defensin, is depressed in patients with AD such that eczematous skin possesses decreased natural resistance to bacterial invasion (Arikawa et al. 2002; Ong et al. 2002) Thus, evidence of clinically apparent skin infection may be a contraindication to occlusive therapy, as it may exacerbate the infection. (Aly et al. 1978) However, the possibility that S. aureus colonization may complicate occlusive therapy has not been adequately addressed to date. Another concern is that the use of topical corticosteroids under occlusion may relate to an increased potential for absorption and greater incidences of possible adverse effects. Most attention has been focused on the risk of skin atrophy and striae, hypothalamic-pituitaryadrenal (HPA) axis suppression, as well as growth impairment in children. Ultimately, this chapter aims to examine current evidence on the safety and efficacy of occlusive therapy in the treatment of AD. 2. Methods Studies on the use of occlusive therapy for the treatment of atopic dermatitis were identified in PubMed and Embase Medline databases from January 1966 to April 2011, using the key terms "occlusion," "occlusive dressings", "occlusive therapy," "wet wrap," "wet dressings," "dry wrap," "dry dressings," "atopic dermatitis," "dermatitis," and "eczema." Key terms were also searched in combination. Reference lists of relevant publications were manually searched for additional relevant studies. The search was limited to original studies and review articles published in English or with English abstracts, in humans. Studies of small size and those that did not use a controlled or randomized study design were included due to the dearth of published literature on this topic. Publications meeting these criteria were then reviewed for study design, population, disease severity or type, study size, efficacy, and safety. The topical agent used, dilution, and type and period of occlusive therapy were also noted, when such information was made available in the publication. In addition, response to therapy was seen as improvement in disease severity or symptoms from baseline, improvement in SCORing Atopic Dermatitis (SCORAD), and/or improvement in Eczema Area and Severity Index (EASI) score, depending on what information was provided. Of note, SCORAD is composite score of eczema...

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The efficacy of a transdermal hydrogel patch containing betamethasone dipropionate for treatment of chronic hand eczema: A single‐blind, randomized and controlled trial

Thaitirarot,

Shuwisitkul,

Udompataikul

et al. 2023

Contact Dermatitis

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BackgroundTopical corticosteroids under occlusion have been used to enhance the treatment of eczema. However, no study has investigated the efficacy of a steroid‐containing transdermal patch for the treatment of chronic hand eczema.MethodsWe conducted a randomized, controlled, assessor‐blinded trial to determine the efficacy of a transdermal patch containing betamethasone dipropionate compared to topical betamethasone dipropionate ointment in the treatment of mild to moderate chronic hand eczema. The patients were included and assigned to receive either the transdermal patch once daily at night or the ointment twice daily for a period of 8 weeks. The outcomes were assessed using the Hand Eczema Severity Index (HECSI), Physical Global Assessment (PGA) score, self‐reported compliance, level of patient satisfaction, quality of life, and side effects.ResultsFifty‐six patients completed this study. At 8 weeks, there was a significant reduction in the HECSI scores in both the transdermal patch and topical ointment groups compared to those measured at baseline (14.61 to 1.86, p < 0.001; 18.46 to 3.43, p < 0.001, respectively) without a statistically significant difference between the two groups. Similarly, the two groups did not show any significant difference in the PGA scores, quality of life and side effects. However, the transdermal patch group reported better compliance and a higher level of patient satisfaction than the topical ointment group.ConclusionThe transdermal corticosteroid patch has proven to be a safe and effective treatment, comparable to topical corticosteroids, after 8 weeks of use. Its sustained‐release properties, along with once‐daily use, can improve patient satisfaction and promote greater adherence to the treatment.Trial RegistrationThis study was registered with the Thai Clinical Trials Registry (www.clinicaltrials.in.th) under registration number TCTR20220413003.

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Instant barrier repair: a pilot study investigating occlusion with a new hydrogel patch for the treatment of atopic dermatitis

Cited by 4 publications

References 3 publications

Filaggrin Mutations and the Atopic March

Filaggrin Mutations and the Atopic March

Occlusive Therapy in Atopic Dermatitis

The efficacy of a transdermal hydrogel patch containing betamethasone dipropionate for treatment of chronic hand eczema: A single‐blind, randomized and controlled trial

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