An Investigator Blinded, Clinical Trial Assessing the Efficacy of Superfine Merino Wool Base Layer Garments (SMWBG) in Children with Atopic Dermatitis (AD) Measuring SCORAD1, EASI2, POEM3 and DSA4 Scores
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 7, Issue 1
Abstract
Atopic Dermatitis (AD) is a chronic inflammatory skin disease, which occurs most often in children compared with the adult AD population [5]. Wool is commonly considered an allergen and trigger for exacerbation of AD. However, Super Fine Merino Wool (SMW) has not been extensively studied and may show some effect in improving AD symptoms such as itch, erythema and induration. To explore this hypothesis, we performed an investigator blinded, repeated measures, self-controlled experimental design study with Super Fine Merino Base Layer Garments (SMWBG). SMWBG were worn by 29 patients with AD between the ages of 6 to 25 years over a 15 week period. We examined the tolerability and potential therapeutic effect of SMWBG (garments worn directly against the skin) in children and young adults with atopic dermatitis (AD). Response was assessed using validated scoring scales: Severity Scoring of Atopic Dermatitis (SCORAD1), Eczema Area Severty Index (EASI2), Patient-Orientated Eczema Measures (POEM3) and a non-validated Dermatitis Severity Assessment (DSA4). Wilcoxon signed-rank tests were conducted to measure the difference between garment intervention phases. Statistically significant results were observed between the pre-garment intervention phase and the with-garment interventionphases for many of the scores. Results found that SMWBG were well-tolerated in children and young adults as an adjunctive therapy for the treatment of AD. This study was conducted in Brisbane, Australia between July 2014 and October 2015 and is Human Research Ethics Committee (HREC) approved. Atopic Dermatitis (AD), otherwise known as eczema is a chronic inflammatory skin disease. AD occurs most often in children and the treatment options available are more complex when compared with the adult AD population [1]. The three prescribed main treatments in AD are: emollients, topical corticosteroids (TCS) and systemic therapies. TCS and diligent emollient application remain the mainstay of AD therapy. Systemic therapy and longterm TCS use have potential problems including skin atrophy and immuno suppression. There is a need for safer and better-tolerated alternatives in the management of AD [6]. There has been a wellestablished assumption that cotton, poly-cotton and silk are the preferred garment fabric choices for people with sensitive skin [7,8]. Superfine Merino Wool (SMW) has been demonstrated to have little or no skin irritancy and has superior thermal and moisture buffering properties than other fabric options and therefore, may be suitable in patients with AD [9,10]. Previous associations with wool and the prickle sensation have been further clarified as being related to a neurological response to fiber diameter irrespective of the fiber type [11,12]. The tolerability of SMWBG in adults with AD has been addressed in a previous study by [4] in 29 adult participants [4]. This study seeks to test the following Hypotheses: a) Hypothesis 1: The fabric characteristics of SMWBG will be well tolerated as an adjunct therapy in participants with AD. b) Hypothesis 2: When SMWBG are worn by children and young adults, they will experience a reduction in their AD symptoms and signs.
Authors and Affiliations
Spelman Lynda Jane, Supranowicz Madeleine Jane, Davidson Kurt Alan, Johnston Jesse James, Yau Benny, Holland Teagan Lea
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