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Efficacy and patient opinion of wet‐wrap dressings using 0.1% triamcinolone acetonide ointment vs cream in the treatment of pediatric atopic dermatitis: A randomized split‐body control study
Author(s) -
Cadmus Simi D.,
Sebastian Katherine R.,
Warren Donald,
Hovinga Collin A.,
Croce Emily A.,
Reveles Liana A.,
Levy Moise L.,
Diaz Lucia Z.
Publication year - 2019
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13830
Subject(s) - medicine , triamcinolone acetonide , atopic dermatitis , dermatology , randomized controlled trial , significant difference , patient satisfaction , surgery
Background Wet wraps can be an effective means of improving atopic dermatitis ( AD ). Little research has been done regarding the comparative efficacy of topical steroid vehicles and patient preference. Objective This study aimed to compare the efficacy of 0.1% triamcinolone acetonide ointment vs cream used with wet wraps in pediatric patients with AD and to explore patient preference/opinion. Methods We performed a small, randomized, investigator‐blind prospective study of 39 pediatric patients experiencing symmetric, bilateral AD flares. Patients were instructed to apply a topical steroid cream to one extremity and apply the same topical steroid in an ointment vehicle to the other extremity using the wet‐wrap technique once or twice daily for 3 to 5 consecutive days. Patients were evaluated at a follow‐up visit. Results Comparison of the change in Investigator’s Global Assessment scores disclosed no significant difference between efficacy ratings of cream (mean difference = 0.72) and ointment (mean difference = 0.59) when used with wet wraps ( P = 0.22). Although patients found the ointment more difficult to apply, they were more likely to prefer ointments for future prescriptions ( P < 0.01). Conclusion Patient preference of corticosteroid vehicle is what should ultimately drive treatment. In this small study, we found no difference in efficacy between triamcinolone acetonide wet wraps with cream vs ointment. Dermatologists should select the vehicle of the patient's choice as it may increase satisfaction with treatment.