Prospective Trial Comparing Topical Steroid Application To Wet Versus Dry Skin In Children With Atopic Dermatitis

PROSPECTIVE TRIAL COMPARING TOPICAL STEROID APPLICATION TO WET VERSUS DRY SKIN IN CHILDREN WITH ATOPIC DERMATITIS. Lucinda S. Liu, Yanna Kang, and Richard J. Antaya. Department of Dermatology, Yale University School of Medicine, New Haven, CT. The aim of this study was to determine whether “soak and smear,” a technique where hydration via a 10-minute soak in lukewarm plain water followed by topical corticosteroid application to wet skin, is efficacious for the treatment of atopic dermatitis in pediatric patients. A randomized, investigator-blinded study was conducted with 45 patients, 4 months to 16 years of age, with moderate to severe atopic dermatitis. All patients received fourteen days of topical corticosteroid ointment and were randomly assigned to either apply the corticosteroid on wet skin via the soak and smear method (treatment arm) or on dry skin (control arm). The primary outcome measure was percentage improvement by Eczema Area and Severity Index (EASI) score. Atopic dermatitis severity of patients who applied corticosteroid ointment to wet skin via soak and smear improved 84.8% by EASI score, whereas atopic dermatitis severity of patients who applied corticosteroid ointment to dry skin improved 81.4% by EASI score. There was no statistical difference between the two groups (p-value = 0.85). The use of corticosteroid application to pre-hydrated, wet skin is not more efficacious than corticosteroid application to dry skin in pediatric patients with moderate to severe atopic dermatitis.