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Vol. 214, No. 1, 2007
Issue release date: December 2006
Dermatology 2007;214:61–67

The Steroid-Sparing Effect of an Emollient Therapy in Infants with Atopic Dermatitis: A Randomized Controlled Study

Grimalt R. · Mengeaud V. · Cambazard F.
aHospital Clinic, University of Barcelona, Barcelona, Spain; bInstitut de Recherche Pierre Fabre, Ramonville, and cService de Dermatologie, Hôpital Nord, Saint-Etienne, France

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Background: No study has clearly demonstrated the steroid-sparing effect of emollients in the treatment of atopic dermatitis (AD). Aim: Evaluating the effect of an emollient containing oat extracts on the amount of topical corticosteroids used in infants with moderate to severe AD. Study Design: During 6 weeks, 173 infants under 12 months old treated for inflammatory lesions by moderate- and/or high-potency topical corticosteroids randomly received the emollient or not (control group). Methods: Evaluation of corticosteroid consumption by weighing the tubes, disease severity by the Scoring Atopic Dermatitis Index (SCORAD), and infants’ and parents’ quality of life by Infant’s Dermatitis Quality of Life Index and Dermatitis Family Impact scores at D0, D21 and D42. Results: Compared to the control group, the amount of moderate- and high-potency corticosteroids used in 6 weeks decreased by 7.5% (not significant) and 42% (p < 0.05), respectively, in the emollient group. The SCORAD index, and infants’ and parents’ quality of life significantly improved (p < 0.0001) in both groups. Conclusion: The emollient treatment significantly reduced the high-potency topical corticosteroid consumption in infants with AD.

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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  1. Haagerup A, Bjerke T, Schiotz PO, Dahl R, Binderup HG, Tan Q, Kruse TA: Atopic dermatitis – a total genome-scan for susceptibility genes. Acta Derm Venereol 2004;84:346–352.
  2. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee: Worldwide variation in prevalence of symptoms of asthma, allergic rhino-conjunctivitis, and atopic eczema: ISAAC. Lancet 1998;351:1225–1232.
  3. Laughter D, Istvan JA, Tofte SJ, Hanifin JM: The prevalence of atopic dermatitis in Oregon school children. J Am Acad Dermatol 2000;43:649–655.
  4. Werner Y, Lindberg M: Transepidermal water loss in dry and clinically normal skin in patients with atopic dermatitis. Acta Derm Venereol 1985;65:102–105.
  5. Loden M: The skin barrier and use of moisturizers in atopic dermatitis. Clin Dermatol 2003;21:145–157.
  6. Sator PG, Schmidt JB, Honigsmann H: Comparison of epidermal hydration and skin surface lipids in healthy individuals and in patients with atopic dermatitis. J Am Acad Dermatol 2003;48:352–358.
  7. Imokawa G, Abe A, Jin K, Higaki Y, Kawashima M, Hidano A: Decreased level of ceramides in stratum corneum of atopic dermatitis: an etiologic factor in atopic dry skin? J Invest Dermatol 1991;96:523–526.
  8. Imokawa G: Lipid abnormalities in atopic dermatitis. J Am Acad Dermatol 2001;45:S29–S32.
  9. Berard F, Marty JP, Nicolas JF: Allergen penetration through the skin. Eur J Dermatol 2003;13:324–330.
  10. Chamlin SL, Kao J, Frieden IJ, Sheu MY, Fowler AJ, Fluhr JW, Williams ML, Elias PM: Ceramide-dominant barrier repair lipids alleviate childhood atopic dermatitis: changes in barrier function provide a sensitive indicator of disease activity. J Am Acad Dermatol 2002;47:198–208.
  11. Loden M: Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders. Am J Clin Dermatol 2003;4:771–788.
  12. Loden M, Andersson AC, Lindberg M: Improvement in skin barrier function in patients with atopic dermatitis after treatment with a moisturizing cream (Canoderm). Br J Dermatol 1999;140:264–267.
  13. Pigatto PD, Bigardi AS, Cannistraci C, Picardo M: 10% urea cream (Laceram) for atopic dermatitis: a clinical and laboratory evaluation. J Dermatolog Treat 1996;7:171–175.

    External Resources

  14. Aries MF, Vaissiere C, Pinelli E, Pipy B, Charveron M: Avena Rhealba inhibits A23187-stimulated arachidonic acid mobilization, eicosanoid release, and cPLA2 expression in human keratinocytes: potential in cutaneous inflammatory disorders. Biol Pharm Bull 2005;28:601–606.
  15. Eichenfield LF, Hanifin JM, Luger TA, Stevens SR, Pride HB: Consensus conference on pediatric atopic dermatitis. J Am Acad Dermatol 2003;49:1088–1095.
  16. Hanifin JM, Cooper KD, Ho VC, Kang S, Krafchik BR, Margolis DJ, Schachner LA, Sidbury R, Whitmore SE, Sieck CK, Van Voorhees AS: Guidelines of care for atopic dermatitis, developed in accordance with the American Academy of Dermatology (AAD)/American Academy of Dermatology Association ‘Administrative Regulations for Evidence-Based Clinical Practice Guidelines’. J Am Acad Dermatol 2004;50:391–404.
  17. Darsow U, Lubbe J, Taieb A, Seidenari S, Wollenberg A, Calza AM, Giusti F, Ring J; European Task Force on Atopic Dermatitis: Position paper on diagnosis and treatment of atopic dermatitis. J Eur Acad Dermatol Venereol 2005;19:286–295.
  18. Williams HC: Clinical practice: atopic dermatitis. N Engl J Med 2005;352:2314–2324.
  19. Lucky AW, Leach AD, Laskarzewski P, Wenck H: Use of an emollient as a steroid-sparing agent in the treatment of mild to moderate atopic dermatitis in children. Pediatr Dermatol 1997;14:321–324.
  20. Muzaffar F, Hussain I, Rani Z, Aziz A, Sultan B: Emollients as an adjunct therapy to topical corticosteroids in children with mild to moderate atopic dermatitis. J Pakistan Assoc Dermatol 2002;12: 64–68.
  21. Kunz B, Oranje AP, Labreze L, Stalder JF, Ring J, Taieb A: Clinical validation and guidelines for the SCORAD index: consensus report of the European Task Force on Atopic Dermatitis. Dermatology 1997;195:10–19.
  22. Lewis-Jones MS, Finlay AY, Dykes PJ: The Infants’ Dermatitis Quality of Life Index. Br J Dermatol 2001;144:104–110.
  23. Lawson V, Lewis-Jones MS, Finlay AY, Reid P, Owens RG: The family impact of childhood atopic dermatitis: the Dermatitis Family Impact Questionnaire. Br J Dermatol 1998;138:107–113.
  24. Green C, Colquitt JL, Kirby J, Davidson P: Topical corticosteroids for atopic eczema: clinical and cost effectiveness of once-daily vs. more frequent use. Br J Dermatol 2005;152:130–141.
  25. Hoare C, Li Wan Po A, Williams H: Systematic review of treatments for atopic eczema. Health Technol Assess 2000;4:1–191.
  26. Cork MJ, Britton J, Butler L, Young S, Murphy R, Keohane SG: Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol 2003;149:582–589.
  27. Hanifin JM, Hebert AA, Mays SR, Paller AS, Sherertz EF, Wagner AM, Tuley MR, Baker MD: Effects of a low-potency corticosteroid lotion plus moisturizing regimen in the treatment of atopic dermatitis. Curr Ther Res 1998;59:227–233.
  28. Charman C, Chambers C, Williams H: Measuring atopic dermatitis severity in randomized controlled clinical trials: what exactly are we measuring? J Invest Dermatol 2003;120:932–941.
  29. Foelster-Holst R, Nagel F, Zoellner P, Spaeth D: Efficacy of crisis intervention treatment with topical corticosteroids prednicarbat with and without partial wet-wrap dressing in atopic dermatitis. Dermatology 2006;212:66–69.
  30. Finlay AY: Quality of life in atopic dermatitis. J Am Acad Dermatol 2001;45:S64–S66.
  31. Fivenson D, Arnold RJ, Kaniecki DJ, Cohen JL, Frech F, Finlay AY: The effect of atopic dermatitis on total burden of illness and quality of life on adults and children in a large managed care organization. J Manag Care Pharm 2002;8:333–342.

    External Resources

  32. Chamlin SL, Frieden IJ, Williams ML, Chren MM: Effects of atopic dermatitis on young American children and their families. Pediatrics 2004;114:607–611.
  33. Ben-Gashir MA, Seed PT, Hay RJ: Quality of life and disease severity are correlated in children with atopic dermatitis. Br J Dermatol 2004;150:284–290.

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