Topical Steroids under Wet-Wrap Dressings in Atopic Dermatitis – A Vehicle-Controlled Trial

BACKGROUND: The wet-wrap dressing technique has proved to be beneficial in cases of exacerbated atopic dermatitis (AD) skin lesions. OBJECTIVE: The effect of wet-wrap dressings was investigated in a controlled trial comparing a steroid (mometasone furoate 0.1%)-containing and a steroid-free (vehicle) preparation in an in-patient comparison study. METHODS: 20 children aged 2-17 years with exacerbated AD were treated twice daily with wet-wrap dressings over a 5-day period. RESULTS: AD in treated areas significantly improved in both study arms; however, the effect was significantly better in the mometasone-treated group (p < 0.01). Transepidermal water loss improved in both arms without any significant differences. Staphylococcus aureus colonization decreased during the first 3 days of active treatment independently of the therapeutic modalities chosen. At day 5, colony counts further dropped on the steroid-treated lesions. CONCLUSION: Application of the wet-wrap dressing technique for exacerbated AD lesions is effective, combination with a topical steroid being superior to a steroid-free application without bearing the risk of a bacterial superinfection.