Su Yuen Ng1, Sabeera Begum1, Sze Yee Chong2. 1. Paediatrics, Institut Pediatrik, Hospital Kuala Lumpur, Jalan Pahang, Kuala Lumpur, Wilayah Persekutuan, Malaysia. 2. Paediatrics, Hospital Selayang, Selayang, Selangor, Malaysia.
Abstract
BACKGROUND: Atopic eczema (AE) is a common chronic inflammatory skin disorder in children, with emollients and topical corticosteroids (TCSs) commonly prescribed as treatment. There is no published guidance on the correct order of application of emollient and TCS in children with AE. OBJECTIVE: The objective of this study was to determine whether the order of application of emollient and TCS makes a difference in the severity of AE in children. METHODS:Forty-six patients ages 4 months to 5 years with moderate to severe AE were randomized to two groups: group A applied emollient followed by TCS 15 minutes later twice daily, and group B applied TCS followed by emollient 15 minutes later twice daily for 2 weeks. RESULTS: There was no statistically significant difference in the Eczema Area and Severity Index (EASI) score, percentage of body surface area (BSA) affected, or itch score between groups A and B (p > 0.05). Group A had statistically significant improvement in the EASI score, percentage BSA affected, and itch score from baseline to weeks 1 and 2; group B demonstrated statistically significant improvement only in the EASI score from baseline to week 1 and in itch score from baseline to week 2. There was no difference in adverse events between the groups. CONCLUSION: This study suggests that the order of application of emollient and TCS does not matter in the treatment of AE in children and that parents can apply topical medications in whichever order they prefer.
RCT Entities:
BACKGROUND:Atopic eczema (AE) is a common chronic inflammatory skin disorder in children, with emollients and topical corticosteroids (TCSs) commonly prescribed as treatment. There is no published guidance on the correct order of application of emollient and TCS in children with AE. OBJECTIVE: The objective of this study was to determine whether the order of application of emollient and TCS makes a difference in the severity of AE in children. METHODS: Forty-six patients ages 4 months to 5 years with moderate to severe AE were randomized to two groups: group A applied emollient followed by TCS 15 minutes later twice daily, and group B applied TCS followed by emollient 15 minutes later twice daily for 2 weeks. RESULTS: There was no statistically significant difference in the Eczema Area and Severity Index (EASI) score, percentage of body surface area (BSA) affected, or itch score between groups A and B (p > 0.05). Group A had statistically significant improvement in the EASI score, percentage BSA affected, and itch score from baseline to weeks 1 and 2; group B demonstrated statistically significant improvement only in the EASI score from baseline to week 1 and in itch score from baseline to week 2. There was no difference in adverse events between the groups. CONCLUSION: This study suggests that the order of application of emollient and TCS does not matter in the treatment of AE in children and that parents can apply topical medications in whichever order they prefer.
Authors: Stephanie J Lax; Jane Harvey; Emma Axon; Laura Howells; Miriam Santer; Matthew J Ridd; Sandra Lawton; Sinéad Langan; Amanda Roberts; Amina Ahmed; Ingrid Muller; Long Chiau Ming; Saumya Panda; Pavel Chernyshov; Ben Carter; Hywel C Williams; Kim S Thomas; Joanne R Chalmers Journal: Cochrane Database Syst Rev Date: 2022-03-11
Authors: Panayiotis Christodoulides; Yoshito Hirata; Elisa Domínguez-Hüttinger; Simon G Danby; Michael J Cork; Hywel C Williams; Kazuyuki Aihara; Reiko J Tanaka Journal: Philos Trans A Math Phys Eng Sci Date: 2017-06-28 Impact factor: 4.226