Topical Sodium Cromoglycate in Atopic Dermatitis A Disappointing but Informative Trial

Abstract

Forty children with atopic eczema requiring topical steroids entered a double-blind group comparative study over 12 weeks and were randomized to either 4% sodium cromoglycate (SCG) in an oil-in-water cream or matching placebo cream. The eczema was evaluated on area charts for 20 parts of the body at five clinic visits. In addition, the families kept diaries on symptoms and treatment. After 3 weeks there were small but statistically significant decreases in severity scores recorded at the clinical visits in the SCG group compared with small increases in the placebo group. However, there were no statistically significant differences in the diary card data during the first 3 weeks of treatment or in any other period, nor were significant differences found in any efficacy data collected during the other 9 weeks of the trial. There were no marked differences in treatment opinions, unusual symptoms, skin infections, use of topical steroids or drugs, or acceptability data between the groups. Staphylococcus aureus was found once or twice in cultures from eczema lesions in 31 of 40 children with no marked group difference. The trial showed that there is great need for improved information, family support and topical as well as general treatment in childhood atopic eczema, but topical SCG did not relieve the patients' eczema.

Extensively and partially hydrolysed infant formulas for allergy prophylaxis

“…We carried out a detailed evaluation of infants with atopic dermatitis using a scoring system by which the body surface was divided into 20 areas. All areas were classified according to redness, excoriations, lichenification, and vesiculation by a four degree scoring system from zero to three 22. The sums of these scores were then used in the statistical calculations.…”

Atopic dermatitis and cromolyn

“…As reported in a letter shortly thereafter, Thirumoorthy and Greaves were unable to demonstrate any benefit from cromolyn sodium when 11 patients with moderate to severe atopic dermatitis applied 10% cromolyn ointment to one side of the body and placebo ointment to the other [7]. Similariy, Kjellman's double-blind comparative group trial of 4% cromolyn cream in 40 children with moderately severe eczema failed to alter itching, overall severity, or use of hydrocorlisone compared to placebo [8]. Interestingly, an improvement in mean area of involvement was found in the cromolyn group.…”

Mast cell mediators other than histamine induce pruritus in atopic dermatitis patients: a dermal microdialysis study

“…3,4 Clinical studies of mast cell degranulation inhibition in AD patients have produced divergent results with both improvement of the eczema seen in some, 5,6 but not all studies. Several authors describe an increased density of mast cells in AD 1,2 and speculate on the pathophysiological relevance of mast cells in AD.…”