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.

An electronic approach to minimising moisture-associated skin damage in ostomy patients

“…Providing the concentration of HOCl is small, then the risk would appear to be minor. Far from exacerbating the irritation, its use as an antibacterial is well recognised [58][59][60] and topical application has also been shown to be beneficial in the treatment of atopic dermatitis [60][61][62]. Nevertheless, the CER process can be minimised in favour of the OER system through further electrode modification whereby perfluorosulphonated (Nafion Ò ) membranes are employed to enable proton transport while limiting chloride access [42,43].…”

“…Dealing with the molecular cocktail will be far from simple -the large potentials will induce the oxidation of other components within the effluent. The ubiquitous presence of chloride ion within biofluids creates a particular problem in that the high potentials imposed at the anode mesh will induce the oxidation of the anion resulting in the generation of various active chlorine species -particularly hypochlorous acid (HOCl) [58][59][60][61][62]. The chlorine evolution reaction (CER) is a competing reaction to the OER and in many cases will be favoured as, in the majority of cases, it requires a smaller overpotential compared to the OER [42,43,58].…”

Primary immunodeficiency update

“…For those who are not able or willing to use dilute bleach baths, chlorhexidine or sodium hypochlorite containing washes may be helpful. 12 In contrast to DOCK8 and atopic patients with high serum IgE levels, anaphylaxis is rare and food allergies are not a major concern in AD-HIES, although the latter is more prevalent in AD-HIES than in the general population. 13, 14 …”

Abordagem da dermatite atópica na infância pelo Médico de Família e Comunidade

“…1,2 Normalmente, manifesta-se nos primeiros anos de vida, podendo persistir durante a vida adulta e ser também a primeira manifestação de uma doença atópica. 2,3 Sua prevalência varia de acordo com a localização geográfica, grau de escolaridade da população e faixa etária. 4 Na Europa, acomete 7-20% das crianças e, no mundo, tem prevalência de 10-20%, com predomínio na faixa etária de 0 a 2 anos.…”