Evaluation of non-steroidal ointment therapy for adult type atopic dermatitis: inquiry analysis on clinical effect

• Published in: Journal of dermatological science Vol. 14; no. 1; pp. 37 - 44
• Main Authors: Katayama, Ichiro, Taniguchi, Hiroko, Matsunaga, Tsuyoshi, Yokozeki, Hiroo, Nishioka, Kiyoshi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ireland Ltd 1997
• Subjects: Adolescent; Adult; Adult type; Age of Onset; Atopic dermatitis; Child; Dermatitis, Atopic - drug therapy; Dermatitis, Atopic - etiology; Dermatitis, Atopic - pathology; Female; Humans; Japan; Male; Middle Aged; Ointments - therapeutic use; Rebound phenomenon; Recurrence; Steroid; Steroids - administration & dosage; Steroids - adverse effects; Japan; Steroid; Atopic dermatitis; Rebound phenomenon; Adult type
• ISSN: 0923-1811; 1873-569X
• DOI: 10.1016/S0923-1811(96)00547-6

Clinical analysis was performed on non-steroidal ointment therapy for 70 patients with refractory adult-type atopic dermatitis by the clinical data and patient's own evaluation of the therapy obtained through enquiries after discharge from the hospital. Forty cases (57%) were between 20 and 30 years old and the male and female ratio was 39 31 . The clinical evaluations were subdivided into five groups; conditions worsened ( n = 9), no-change ( n = 9), slightly improved ( n = 14), much improved ( n = 29) and cured ( n = 9). Although statistically not significant, the age of onset of atopic dermatitis and the start of use of steroid ointment was much higher while the duration of the atopic dermatitis was much shorter in the remission patients. The duration of steroid ointment therapy for the facial skin was significantly shorter in the remission group when compared to groups with worsened symptoms and no-change in symptoms. Family history and complications of atopic diseases, laboratory data including IgE titer, eosinophils and RAST score were not statistically significant in any group except for a higher prevalence of IgE antibodies against inhalant and food allergens in the group with worsened symptoms. Most patients still used steroid ointment on the trunk lesions while they ceased using from the topical steroid on the facial lesions after discharge. Most frequent precipitating factors pointed out by the patients were emotional stress, irritation by sweat or UV light and longstanding use of steroid ointment. Complications of cataracta and retinopathy were found in 12 cases. These results suggest that remission of adult-type refractory atopic dermatitis can be achieved by the combination of careful daily skin care, use of non-steroidal topical ointment and minimizing the precipitating factors.