Correlation between the amount of topical agent and severity in atopic dermatitis
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P6724 Clinical evaluation of pseudoceramide-containing water-in-oil cream among atopic eczema patients Lisa Adams, Kao USA, Cincinnati, OH, United States; Andrea Schultz, Kao USA, Cincinnati, OH, United States; Ward Billhimer, MS, Kao USA, Cincinnati, OH, United States Eczema and atopic dermatitis (AD) are recognized as major health problems worldwide. Within the U.S., prevalence estimates suggest nearly 17% of children and adults are affected and the rate appears to be increasing. Patients with atopic skin present a defective skin barrier function. Most common symptoms include itchy, inflamed skin or dry skin that can be chronic or triggered by other factors such as allergies or asthma causing a ‘‘flare-up.’’ Moisturizing creams containing ceramides or pseudo-ceramide are often used in the treatment of dry and atopic skin conditions to reestablish the intercellular matrix and strengthen the skin barrier. The water-in-oil delivery system works conjunctively with the pseudocer- amide providing an occlusive environment that allows the hydrophobic pseudo- ceramide to trap water in the stratum corneum; thereby improving barrier function and reducing symptoms associated with atopic dermatitis. This study investigated the influence of a pseudoceramide-containing water-in-oil (w/o) cream on the barrier properties of atopic skin during a 4-week use period in children and adults. Twenty-two adult men and women, ages 18 to 61 years, inclusive, with atopic dermatitis completed the study. Additionally, 18 children, ages 10 months to 17 years, with atopic dermatitis completed the study. Dermatologist evaluations using the Eczema Area Severity Index (EASI) were conducted. TEWL and Corneometer data were collected as well as panelist self- assessments at baseline, weeks 2, 4, and regression. Quality of life was assessed at baseline, week 4 and regression. After 4 weeks of product usage, treatment was discontinued and subjects were restricted from using any moisturizing lotions for 1 week to follow the regression of the skin back towards its original atopic state. This highly occlusive w/o emulsion was shown to be safe and effective at improving atopic skin. Significant improvement in EASI (P # .0001) and investigator scoring was observed by the dermatologist after only 2 weeks of using the pseudoceramide w/o cream and continued throughout the 1-week regression period. Significant (P # .001) improvements in stinging, burning, itching and dryness were observed by the patients at the 2-week interval and continued throughout the regression period. By week 4, significant QOL improvements were observed (P # .001). The percent improvement in symp- toms, emotions, and functioning scale scores in the Skindex-16 compared to baseline were 73%, 69%, and 71%, respectively. This clinical study shows the effectiveness of the w/o pseudoceramide cream by improving dry skin, relieving symptoms related to atopic dermatitis and strengthening the skin barrier. Supported by 100% Kao USA. P6383 Correlation between the amount of topical agent and severity in atopic dermatitis Hongsun Lee, MD, Seoul National University Bundang Hospital, Seongnam-si, South Korea; Chang-Hun Huh, MD, Seoul National University Bundang hospital, Seongnam-si, South Korea; Jung-Im Na, MD, Seoul National University Bundang Hospital, Seongnam-si, South Korea Background: Topical immunomodulators (TIMS) have been widely used and replaced topical steroids all over the world for many years. But generally patients could not maximize the effect because they did not follow recommended dose. We would like to know the relationship between the amount of used and efficacy for the treatment of atopic dermatitis. Methods: 750 mild to moderate atopic dermatitis patients from 12 treatment centers were recruited. Topical tacrolimus or steroid ointments were prescribed to the patients at least 3 tubes for facial lesion and/or 5 tubes for trunk lesions. Then, they are followed up at week 2 and 4, and EASI scores were checked every visit. All other treatment modalities are prohibited except use of anti-histamine. ANOVA was adapted for statistical analysis. Results: All patients are subdivided into 5 groups: those who apply tacrolimus either face or trunk (Gr. I), both site (Gr. II), tacrolimus on one site and steroid to the other site (Gr. III), steroid on faceor trunk (Gr. IV), steroid on both site (Gr. V). All of the 5 groups were improved after 4 weeks applications of topical ointments, with higher effectiveness in Gr. I to III than Gr. IVor V. Then we subgroup analyze with those who using tacrolimus according to patient’s severity. We could found there’s correlation between EASI score change and amount of topical ointment used, which was greatest in moderate severity (EASI score 2-3.6 at beginning) with face lesion (P ¼ .0087). Conclusion: We found that if patients are properly educated and followed, the topical ointment effect might be greater. Commercial support: None identified. P6469 Cosmetic acceptability of licensed emollients: An in vivo comparison of 2 commercially available products, DELP gel and DIPC cream Jasmina Gallagher, PharmD, PhD, Dermal Laboratories Ltd, Gosmore, United Kingdom; Jennine Walker, Dermal Laboratories Ltd, Hitchin, United Kingdom; Krystyna Sykes, Dermal Laboratories Ltd, Hitchin, United Kingdom; Phil Rosher, PhD, Dermal Laboratories Ltd, Hitchin, United Kingdom; Valerie Hart, RSSL, Reaading, United Kingdom Although emollient effectiveness is of primary importance, treatment concordance depends upon patient satisfaction with the physical characteristics of their chosen emollient. The cosmetic acceptability of a novel, proprietary emollient DELP gel was compared to a marketed comparator, DIPC cream, in a single center, double- blind, bilateral study in patients with dry skin. Patients applied both DELP and DIPC (n ¼ 36) on lower legs twice daily for 5 days. The cosmetic acceptability of both products was recorded on day 5 by asking subjects to choose from the options ‘‘like strongly,’’ ‘‘like slightly,’’ ‘‘neither like nor dislike,’’ ‘‘dislike slightly,’’ and ‘‘dislike strongly.’’ Patients were also asked if they would use each product again and which product they preferred. For DELP, 69% of subjects ticked either ‘‘like slightly’’or ‘‘like strongly,’’ as compared to only33% for DIPC. This difference in overall product acceptability was statistically significant (Prescott’s test; 95% CI; P ¼ .025). 53% of subjects disliked DIPC (‘‘dislike strongly’’ or ‘‘dislike slightly’’) compared to only 12% disliking DELP. Only one-third of subjects (33%) indicated that they would use DIPC again compared to 72% for DELP, and this difference was statistically significant (Prescott’s test; P ¼ .033). Three quarters (75%) of subjects preferred DELP, whilst only 17% preferred DIPC and the remaining 8% of subjects had no preference. This difference was also highly statistically significant (Prescott’s test; P ¼ .0004). Taken overall, the results of this study indicate that there are significant differences in cosmetic acceptability between commercially available licensed emollients. This study was funded by Dermal Laboratories Ltd. P6219 Effect of environmentally friendly wallpaper and flooring material on indoor air quality and atopic dermatitis Chang-Hun Huh, MD, PhD, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea; Jung-Im Na, MD, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea; Kyoung-Chan Park, MD, PhD, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea; Mi-Young Jeong, RN, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea Background: Many atopic dermatitis patients report aggravation of eczema after house remodeling or moving into a newly built house. Formaldehyde (FA) and volatile organic compounds (VOCs) are considered one of the main culprits behind this phenomenon and the main sources of them are wallpaper, painting, adhesives and flooring. Objective: The purpose of this study is to assess the effects of environmentally friendly wall paper and flooring material on indoor air quality and atopic dermatitis severity. Methods: Thirty atopic dermatitis patients were enrolled in this study. To improve the air quality, wallpaper and flooring of subjects’ houses were exchanged to plant or silica made paper and plant made flooring. Indoor air of subjects’ houses was collected and the concentration of FA, total VOCs (TVOCs), total floating microbes and carbon dioxide were measured before remodeling and 2, 6 and 10 weeks after. Pruritus and severity of atopic eczema was evaluated using questionnaire and EASI score (Eczema Area and Severity Index) at before remodeling and 4, 8, and 12 weeks after remodeling. Subjects were instructed to keep their ongoing therapy for atopic dermatitis. Subjects who started systemic corticosteroid, systemic immunosuppressant, or phototherapy during study period were dropped out. Results: Twenty-four subjects’ houses were remodeled and all of them finished the study. FA in ambient air continuously decreased after remodeling. TVOCs level showed decrease at week 2 but reincrease at week 6 and 10. There was no significant change in total floating microbes and carbon dioxide. Level of pruritus and EASI score was reduced after remodeling. The reduction of pruritus and EASI score was statistically significant in patients whose baseline EASI score was over 3. Conclusion: Replacement to environmentally friendly wallpaper and flooring material reduced FA in ambient air and improved pruritus and severity of atopic eczema. Improvement of pruritus and eczema severity was more prominent in patients whose baseline EASI score was over 3. Commercial support: None identified. APRIL 2013 JAM ACAD DERMATOL AB75
Transcript of Correlation between the amount of topical agent and severity in atopic dermatitis
P6724Clinical evaluation of pseudoceramide-containing water-in-oil creamamong atopic eczema patients
Lisa Adams, Kao USA, Cincinnati, OH, United States; Andrea Schultz, Kao USA,Cincinnati, OH, United States; Ward Billhimer, MS, Kao USA, Cincinnati, OH,United States
Eczema and atopic dermatitis (AD) are recognized as major health problemsworldwide. Within the U.S., prevalence estimates suggest nearly 17% of childrenand adults are affected and the rate appears to be increasing. Patients with atopicskin present a defective skin barrier function. Most common symptoms includeitchy, inflamed skin or dry skin that can be chronic or triggered by other factorssuch as allergies or asthma causing a ‘‘flare-up.’’ Moisturizing creams containingceramides or pseudo-ceramide are often used in the treatment of dry and atopicskin conditions to reestablish the intercellular matrix and strengthen the skinbarrier. The water-in-oil delivery system works conjunctively with the pseudocer-amide providing an occlusive environment that allows the hydrophobic pseudo-ceramide to trap water in the stratum corneum; thereby improving barrierfunction and reducing symptoms associated with atopic dermatitis. This studyinvestigated the influence of a pseudoceramide-containing water-in-oil (w/o)cream on the barrier properties of atopic skin during a 4-week use period inchildren and adults. Twenty-two adult men and women, ages 18 to 61 years,inclusive, with atopic dermatitis completed the study. Additionally, 18 children,ages 10 months to 17 years, with atopic dermatitis completed the study.Dermatologist evaluations using the Eczema Area Severity Index (EASI) wereconducted. TEWL and Corneometer data were collected as well as panelist self-assessments at baseline, weeks 2, 4, and regression. Quality of life was assessed atbaseline, week 4 and regression. After 4 weeks of product usage, treatment wasdiscontinued and subjects were restricted from using any moisturizing lotions for1 week to follow the regression of the skin back towards its original atopic state.This highly occlusive w/o emulsion was shown to be safe and effective atimproving atopic skin. Significant improvement in EASI (P # .0001) andinvestigator scoring was observed by the dermatologist after only 2 weeks ofusing the pseudoceramide w/o cream and continued throughout the 1-weekregression period. Significant (P # .001) improvements in stinging, burning,itching and dryness were observed by the patients at the 2-week interval andcontinued throughout the regression period. By week 4, significant QOLimprovements were observed (P # .001). The percent improvement in symp-toms, emotions, and functioning scale scores in the Skindex-16 compared tobaseline were 73%, 69%, and 71%, respectively. This clinical study shows theeffectiveness of the w/o pseudoceramide cream by improving dry skin, relievingsymptoms related to atopic dermatitis and strengthening the skin barrier.
APRIL 20
d by 100% Kao USA.
SupporteP6383Correlation between the amount of topical agent and severity in atopicdermatitis
Hongsun Lee, MD, Seoul National University Bundang Hospital, Seongnam-si,South Korea; Chang-Hun Huh, MD, Seoul National University Bundang hospital,Seongnam-si, South Korea; Jung-Im Na, MD, Seoul National University BundangHospital, Seongnam-si, South Korea
Background: Topical immunomodulators (TIMS) have been widely used andreplaced topical steroids all over the world for many years. But generally patientscould not maximize the effect because they did not follow recommended dose. Wewould like to know the relationship between the amount of used and efficacy for thetreatment of atopic dermatitis.
Methods: 750 mild to moderate atopic dermatitis patients from 12 treatment centerswere recruited. Topical tacrolimus or steroid ointments were prescribed to thepatients at least 3 tubes for facial lesion and/or 5 tubes for trunk lesions. Then, theyare followed up at week 2 and 4, and EASI scores were checked every visit. All othertreatment modalities are prohibited except use of anti-histamine. ANOVA wasadapted for statistical analysis.
Results: All patients are subdivided into 5 groups: those who apply tacrolimuseither face or trunk (Gr. I), both site (Gr. II), tacrolimus on one site and steroid tothe other site (Gr. III), steroid on face or trunk (Gr. IV), steroid on both site (Gr. V).All of the 5 groups were improved after 4 weeks applications of topical ointments,with higher effectiveness in Gr. I to III than Gr. IV or V. Then we subgroup analyzewith those who using tacrolimus according to patient’s severity. We could foundthere’s correlation between EASI score change and amount of topical ointmentused, which was greatest in moderate severity (EASI score 2-3.6 at beginning) withface lesion (P ¼ .0087).
Conclusion: We found that if patients are properly educated and followed, thetopical ointment effect might be greater.
cial support: None identified.
Commer13
P6469Cosmetic acceptability of licensed emollients: An in vivo comparison of 2commercially available products, DELP gel and DIPC cream
Jasmina Gallagher, PharmD, PhD, Dermal Laboratories Ltd, Gosmore, UnitedKingdom; Jennine Walker, Dermal Laboratories Ltd, Hitchin, United Kingdom;Krystyna Sykes, Dermal Laboratories Ltd, Hitchin, United Kingdom; Phil Rosher,PhD, Dermal Laboratories Ltd, Hitchin, United Kingdom; Valerie Hart, RSSL,Reaading, United Kingdom
Although emollient effectiveness is of primary importance, treatment concordancedepends upon patient satisfaction with the physical characteristics of their chosenemollient. The cosmetic acceptability of a novel, proprietary emollient DELP gelwas compared to a marketed comparator, DIPC cream, in a single center, double-blind, bilateral study in patients with dry skin. Patients applied both DELP andDIPC (n ¼ 36) on lower legs twice daily for 5 days. The cosmetic acceptability ofboth products was recorded on day 5 by asking subjects to choose from theoptions ‘‘like strongly,’’ ‘‘like slightly,’’ ‘‘neither like nor dislike,’’ ‘‘dislike slightly,’’and ‘‘dislike strongly.’’ Patients were also asked if they would use each productagain and which product they preferred. For DELP, 69% of subjects ticked either‘‘like slightly’’ or ‘‘like strongly,’’ as compared to only 33% for DIPC. This differencein overall product acceptability was statistically significant (Prescott’s test; 95% CI;P ¼ .025). 53% of subjects disliked DIPC (‘‘dislike strongly’’ or ‘‘dislike slightly’’)compared to only 12% disliking DELP. Only one-third of subjects (33%) indicatedthat they would use DIPC again compared to 72% for DELP, and this difference wasstatistically significant (Prescott’s test; P ¼ .033). Three quarters (75%) of subjectspreferred DELP, whilst only 17% preferred DIPC and the remaining 8% of subjectshad no preference. This difference was also highly statistically significant(Prescott’s test; P ¼ .0004). Taken overall, the results of this study indicate thatthere are significant differences in cosmetic acceptability between commerciallyavailable licensed emollients.
y was funded by Dermal Laboratories Ltd.
This studP6219Effect of environmentally friendly wallpaper and flooring material onindoor air quality and atopic dermatitis
Chang-Hun Huh, MD, PhD, Seoul National University Bundang Hospital,Seongnam, Gyeonggi, South Korea; Jung-Im Na, MD, Seoul National UniversityBundang Hospital, Seongnam, Gyeonggi, South Korea; Kyoung-Chan Park, MD,PhD, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, SouthKorea; Mi-Young Jeong, RN, Seoul National University Bundang Hospital,Seongnam, Gyeonggi, South Korea
Background: Many atopic dermatitis patients report aggravation of eczema afterhouse remodeling or moving into a newly built house. Formaldehyde (FA) andvolatile organic compounds (VOCs) are considered one of the main culprits behindthis phenomenon and the main sources of them are wallpaper, painting, adhesivesand flooring.
Objective: The purpose of this study is to assess the effects of environmentallyfriendly wall paper and flooring material on indoor air quality and atopic dermatitisseverity.
Methods: Thirty atopic dermatitis patients were enrolled in this study. To improvethe air quality, wallpaper and flooring of subjects’ houses were exchanged toplant or silica made paper and plant made flooring. Indoor air of subjects’ houseswas collected and the concentration of FA, total VOCs (TVOCs), total floatingmicrobes and carbon dioxide were measured before remodeling and 2, 6 and 10weeks after. Pruritus and severity of atopic eczema was evaluated usingquestionnaire and EASI score (Eczema Area and Severity Index) at beforeremodeling and 4, 8, and 12 weeks after remodeling. Subjects were instructedto keep their ongoing therapy for atopic dermatitis. Subjects who startedsystemic corticosteroid, systemic immunosuppressant, or phototherapy duringstudy period were dropped out.
Results: Twenty-four subjects’ houses were remodeled and all of them finished thestudy. FA in ambient air continuously decreased after remodeling. TVOCs levelshowed decrease at week 2 but reincrease at week 6 and 10. There was nosignificant change in total floating microbes and carbon dioxide. Level of pruritusand EASI score was reduced after remodeling. The reduction of pruritus and EASIscore was statistically significant in patients whose baseline EASI score was over 3.
Conclusion: Replacement to environmentally friendly wallpaper and flooringmaterial reduced FA in ambient air and improved pruritus and severity of atopiceczema. Improvement of pruritus and eczema severity was more prominent inpatients whose baseline EASI score was over 3.
cial support: None identified.
CommerJ AM ACAD DERMATOL AB75
