INTRODUCTION
Repairing the epidermal barrier is critically important in the treatment of atopic dermatitis (AD) and the associated skin dryness (xerosis).1 While frequently recommended, the effectiveness of moisturizer treatment in AD is not well characterized.2 We assessed whether the use of a moisturizer designed for atopic dermatitis improves objective and subjective disease severity in atopic patients with xerosis.
MATERIALS AND METHODS
Thirty-five (35) adult subjects with a diagnosis of xerosis in the context of current or historic AD were recruited from the Department of Dermatology clinics at Atrium Wake Forest Baptist Medical Center. Six patients were excluded due to loss of follow-up. Patients received Cetaphil Pro Eczema moisturizer (Galderma, Ft Worth, TX) equipped with an electronic monitor to measure adherence and were instructed to apply the moisturizer once daily for three months. The use of electronic monitoring was not disclosed until the final visit. Patients were not permitted to apply any other topical moisturizers or prescription treatments during the study period except for daily sunscreen. Xerosis severity was assessed with the Overall Skin Dryness Severity (ODS) score at baseline and follow-up visits. Effect on QOL was assessed with the total and individual Dermatology Life Quality Index (DLQI) scores at baseline and follow-up. At follow-up, the data from the electronic adherence monitors were downloaded. Data were analyzed using the SAS Software 9.4 Differences in group comparisons by mean score were analyzed with a Student's t-test.
RESULTS
Patient demographics included 57% female and 42% male, an average age of 64, and 96% Caucasian. Mean adherence to the moisturizer was 46%. After three months of using the moisturizer, dryness improved from 1.9 at baseline to 1.4 at follow-up (P=0.02). DLQI improved from 3.3 at baseline to 1.5 at 3 months (P=0.005). The "feeling self-conscious or embarrassed due to their skin condition" DLQI item improved from 0.79 at baseline to 0.14 at 3 months (P=0.0009).
DISCUSSION
Xerosis is a common symptom associated with AD that may negatively impact QOL with discomfort, pruritus, and the undesirable appearance of skin.3 Both disease severity and overall QOL improved with the use of a daily moisturizer alone,
