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A Standard Technique Revisited

Ari Benjamin Gutman, MD; Albert M. Kligman, MD, PhD; Joslyn Sciacca, MD; William D. James, MD

Arch Dermatol. 2005;141:1556-1559.

Background  Atopic dermatitis, nummular eczema, chronic hand dermatitis, palmar plantar psoriasis, and xerotic eczema are common inflammatory skin conditions. They may be refractory to conventional topical and even systemic treatment. Little evidence is available that demonstrates the benefits of aggressive topical treatment of patients with these disorders.

Objective  To describe a simple, inexpensive, effective topical treatment with an accompanying patient educational sheet.

Design  A retrospective study of 28 patients referred to a tertiary care center for refractory chronic pruritic eruptions. Intervention with a plain water 20-minute soak followed by smearing of midstrength to high-strength corticosteroid ointment led to clearing or dramatic improvement.

Results  Objective and symptomatic improvement was obtained from aggressive topical treatment. It was well accepted in this group of referral patients.

Conclusions  Hydration for 20 minutes before bedtime followed by ointment application to wet skin and alteration of cleansing habits is an effective method for caring for several common skin conditions. Prospective studies are needed to further validate these findings.

Author Affiliations: University of Pennsylvania School of Medicine, Philadelphia (Drs Gutman, Kligman, and James); and University of Virginia School of Medicine, Charlottesville (Dr Sciacca). Dr Gutman is now with the Department of Dermatology, Albert Einstein College of Medicine, Bronx, New York. Dr Sciacca has changed her name to Dr Joslyn Kirby and is now with the University of Pennsylvania School of Medicine.

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