Treatment of refractory atopic dermatitis using 'wet-wrap' dressings and diluted corticosteroids: results of standardized treatment in both children and adults.

Background: 'Wet-wrap' dressings with diluted corticosteroids form an alternative treatment in patients with refractory atopic dermatitis (AD).

Objective: To evaluate a standardized treatment, using wet-wrap dressings with diluted corticosteroids, in patients with refractory AD.

Methods: Results of treatment, complications and possible side effects were retrospectively evaluated in 14 children and 12 adults.

Results: Skin lesions improved dramatically during 1 week of inpatient treatment. A significant decrease in early-morning serum cortisol levels was measured. Levels below the normal range were only observed after 1 week in 2 adults and on day 4 in 3 children. Suppression of the hypothalamus-pituitary-adrenal-cortex axis in 1 adult and a new exacerbation of AD in 2 children and 3 adults complicated long-term treatment at home. Additional complications included folliculitis, a Pseudomonas aeruginosa infection, a secondary bacterial infection and refractory skin lesions between bandages.

Conclusion: Wet-wrap dressings and diluted corticosteroids form an effective treatment in patients with refractory AD.