Side to side comparison of topical treatment in atopic dermatitis
Department of Child
Health, University of Manchester, Manchester, UK
Correspondence to: Professor T J David, University Department of Child Health, Booth Hall Children's Hospital, Charlestown Road, Blackley, Manchester M9 7AA, UK. e-mail: tim.david{at}dial.pipex.com
Accepted 24 April 1998
OBJECTIVES
To document
and evaluate the outcome of side to side comparisons of different
corticosteroids in determining the most effective topical treatment for
individuals admitted to hospital for control of atopic dermatitis.
METHODSRetrospective
case note study of 82 admissions (66 children) to a children's
hospital for treatment of atopic dermatitis between 1 June 1993 and 31 October 1995. Different topical corticosteroid ointments were
applied to the two sides of the body. The outcome measure was a
comparison between the two sides, to see whether one treatment was
better than the other.
RESULTSMore potent
topical corticosteroid preparations appeared more effective than weaker
preparations on 25 occasions, there was no difference on 20 occasions,
and on seven occasions a weaker preparation appeared more effective.
Incorporation of an antimicrobial agent did not appear to increase the
efficacy of a preparation.
CONCLUSIONSThe
management of atopic dermatitis is bedevilled by considerable
spontaneous fluctuations in severity, leading to uncertainty as to
whether a new treatment is beneficial; a coincidental flare up of the
skin lesions may be wrongly attributed to a particular treatment, which
is then discarded. Comparing different topical treatments
simultaneously on opposite sides of the body is a feasible and rational
way to determine the optimum treatment for an individual with atopic dermatitis.
© 1998 by Archives of Disease in Childhood
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