Objective In order to evaluate the effectiveness and safety of wet-wrap therapy (WWT) for chronic recalcitrant localized eczema. Methods Twenty-five patients (8 men and 17 women) with chronic eczema whose total symptom score (TSS)≥12; investigator's global assessment (IGA) scores ≥4; skin lesion area of 5％～15％ of body surface area (BSA), no improvement after apply strong potency corticosteroid ointment for at least three months were treated from June 2017 to January 2018 in department of dermatology, beijing friendship Hospital. The patients underwent WWT (halometasone cream+ vaseline ointment) once daily and 10 hours a time for 14 days. Eczema area and severity index (EASI), visual analog scale (VAS) for pruritus, IGA and TSS were determined before and 7 d, 14 d after the WWT. Results The absolute EASI reductions from the baseline were significantly decreased on the 7th day and 14th day (-5. 82±1. 54υs. -7. 94±1. 82 t=-18. 89 and-21. 82, both P<0. 001); EASI reduction (％) were (45. 72±8. 18)％ and (62. 86±11. 07)％. The absolute VAS score reductions from the baseline were decreased significantly on day 7 and day 14(-4. 16±1. 18 vs. -5. 76±1. 59, t=-17. 64 and-18. 13, both P<0. 001). On the 14th day of the treatment, 72％ of patients achieved IGA success (IGA scores of 0 or 1); 84％ of patients achieved TSS success defined as (TSS baseline value-TSS after treatment)/TSS at baseline x 100％≥60％. Eleven patients complained tolerable wet dressing-associated discomforts, which resolved after the wet dressing was removed when the WWT was completed. Conclusion WWT can relieve pruritus, reduce skin lesions in patients with chronic recalcitrant eczema. Less adverse events were occurred. Thus, WWT may be effective and safe for severe chronic eczema.%目的 观察湿包疗法(WWT)治疗慢性难治性限局性湿疹的临床疗效和安全性.方法2017年6月-2018年1月在北京友谊医院皮肤科门诊就诊的慢性湿疹患者共25例(男8例,女17例),皮损症状总积分(TSS)≥12分;研究者总体评价(IGA)≥4者;皮损受累面积占的体表面积(BSA);外用强效糖皮质激素药膏至少3个月以上无效者.采用卤米松联合凡士林软膏进行WWT,每晚1次,10h/次,连续治疗14d,评估治疗前后湿疹面积及严重程度指数(EASI)评分、瘙痒自我评分9VAS)、IGA及TSS评分的改善情况.结果治疗后第7天、第14天的EASI评分下降值分别为(-5. 82±1. 54υs. -7. 94±1. 82),治疗前后差异均有统计学意义(t分别为-18. 89、-21. 82,均P<0. 001); EASI下降率分别为(45. 72±8. 18)％和(62. 86±11. 07)％.治疗后第7天、第14天的VAS评分下降值分别为(-4. 16±1. 18υs. -5. 76±1. 59),治疗前后差异均有统计学意义(t分别为-17. 64、-18. 13,均P<0. 001).IGA治疗成功率(IGA评分降为0或1的受试者百分比)为72％;治疗后第14天TSS治疗有效率[(治疗前TSS值-治疗后TSS值)/治疗前TSS值≥60％]为84％.WWT不良反应轻微,11例患者因潮湿引起不适感,治疗结束后自行缓解.结论WWT能显著改善慢性难治性湿疹患者的皮损和瘙痒,不良反应轻微,是重度慢性湿疹治疗的新方法.
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