All subjects continued their previous therapy (e.g.,

topical tacrolimus or corticosteroids), only substituting the barrier-repair emollient for their previous moisturizer. Follow-up SCORAD scores improved significantly in 22 of 24 patients by 3 weeks, with further progressive improvement in all patients between 6 and 20 or 21 weeks. TEWL, which was elevated selleck chemicals over the involved and uninvolved areas at study entry, decreased in parallel with SCORAD scores and continued to decline even after the SCORAD scores plateaued. Stratum corneum integrity and hydration also improved significantly during therapy. The ultrastructure of the stratum corneum following treatment with the ceramide-dominant emollient revealed extracellular lamellar membranes, which were largely absent in baseline stratum corneum samples.

The authors concluded that a ceramide-dominant barrier-repair emollient represents a safe and useful adjunct to the treatment of childhood AD. EpiCeram® consists of a specific combination of ceramides, cholesterol, and fatty acids (in the ratio of 3:1:1), which mimic those naturally found in the skin [27, 28]. Recent studies have shown that EpiCeram® has efficacy similar to that of a mid-potency topical corticosteroid but has a more favorable safety profile [27, 28]. However, those studies did not report objective measurements to demonstrate the efficacy mTOR inhibitor of treatment. Hon et al. [29] studied skin hydration and TEWL on the forearm and determined the SCORAD score, Nottingham Eczema Severity Score (NESS), CDLQI, and amounts of emollient and cleanser used over a 2-week period

in consecutive new patients seen at the pediatric skin clinic. Patients with AD had significantly Liothyronine Sodium greater TEWL and less skin hydration at the studied sites. Although both skin dryness and skin hydration were improved, there was no significant improvement in the SCORAD score or TEWL after 2 weeks. In terms of GAT, three quarters of patients with AD and controls rated the combination of the cream and cleanser as good or very good. The authors concluded that liberal use of emollients and bathing cleanser alone does not seem to alter disease severity or TEWL within 2 weeks, implying that additional treatments are necessary to manage AD [29]. In another study, Hon et al. [13] recruited 33 patients with AD to study the clinical and biophysiological effects of twice-daily application of a pseudoceramide-containing cream. Four weeks after the patients started using the pseudoceramide cream, their skin hydration had improved significantly. There was no deterioration in TEWL, eczema severity, or quality of life in these patients. The pseudoceramide cream improved skin hydration but not eczema severity or quality of life over 4 weeks of use [13, 30].