Emollient Acceptability in Childhood Atopic Dermatitis: Not All Emollients are Equal

摘要

Background: Eczema or Atopic Dermatitis (AD) is a common chronic relapsing skindisease associated with impaired quality of life. Regular usage of moisturizer/emollient is the mainstayof management but acceptability of emollient is often suboptimal. We investigated if emollientacceptability is influenced by various clinical factors in AD.Methods: A survey on frequency of emollient usage, brands, clinical factors including disease severity(Nottingham Eczema Severity Score, NESS), quality of life (Children Dermatology LifeQuality Index, CDLQI), Transpidermal Water Loss (TEWL), and Skin Hydration (SH) was performed.Acceptability was classified as very good, good, fair or poor.Results: We evaluated 128 AD patients. NESS correlated with CDLQI and the treatment domain ofCDLQI. Emollient usage is elementary for AD treatment. 89.1% of patients reported that doctor’srecommendation was the major source of advice when choosing an emollient. Aqueous cream (AQ)and petroleum-derived products were among the commonly used emollients. More aqueous creamusers reported fair/poor acceptability (p=0.017) and lower SH (p<0.05). Linear regression showedthat patients who thought their emollient as fair or poor were currently using AQ (p=0.003), theiremollient not recommended by a doctor (p=0.035), with more severe disease (p=0.04), and hadlower emollient usage in winter (p=0.05).Conclusion: Physicians play a pivotal role in assisting patients to select an emollient that they willaccept and use consistently. The studied emollients are generally acceptable by over 80% patients.However, aqueous cream is least acceptable by patients, making it the least favorable emollient torecommend to patients.