Pilot Study of a Customized Nanotextile Wet Garment Treatment on Moderate and Severe Atopic Dermatitis: A Randomized Clinical Trial

To compare the use of nanotextile (100% nanopolyester) and viscose rayon (Tubifast) garments for wet wrap therapy (WWT) thereby demonstrating nanotextile as a comparable alternative to the conventional material, viscose.

The study included infants and children younger than 18 years of age with moderate to severe atopic dermatitis (AD) from the KK Women’s and Children’s Hospital inpatient ward and dermatology outpatient clinics in Singapore City, Singapore. Exclusion criteria included those with active skin infection, on immunotherapy, and phototherapy.

Patients were recruited between March 4, 2017 to August 8, 2017. Enrolled patients were randomized to undergo viscose or nanotextile WWT in addition to regular eczema treatment. Application of WWT was instructed to occur daily overnight for 2 weeks. On day 0, 7, and 14, self-reported Scoring Atopic Dermatitis (SCORAD) index and the Investigator’s Global Assessment (IGA) Scale were used to measure disease severity. Quality of life (QoL) as it relates to health was measured utilizing the Infant’s Dermatitis Quality of Life Index (IDQOL) in those 4 years of age and younger. In children ages 5–18 years old, the Children’s Dermatitis Life Quality Index (CDLQI) was used to gauge QoL. Patients were also asked to provide feedback on the use of the WWT. On day 0, 7, and 14 of treatment, patients’ disease severity score (IGA and SCORAD) as well as QoL score (IDQOL or CDLQI) were assessed.

The study randomized a total of 53 children from the ages of 7 months to 17 years. Twenty-seven were in the viscose arm and 26 in the nanotextile arm. Disease severity as measured by SCORAD had a mean baseline of 52.3 (SD, 12.8) in the viscose arm and 57.0 (SD, 14.4) (P = .25) in the nanotextile arm. The post-treatment mean SCORAD improvement score was 16.1 in the viscose arm and 19.3 in the nanotextile arm on day 14 (P = .65). Baseline IGA scores in the viscose arm was 3.17 (SD, 0.62) and 3.29 (SD, 0.70) in the nanotextile arm. Similar to the findings with the SCORAD score, mean IGA score improvement in the viscose and nanotextile groups was 1.36 and 1.3, respectively (P = .71). The mean improvement found in QoL on day 14 in the viscose arm was 5.48 and in the nanotextile arm was 6.05 (P = .57). The collected patient feedback scores showed significant preference to nanotextile on the topics of comfort, temperature, and ease of wear.

Nanotextile has a comparable effectiveness to viscose for the use of WWT in moderate to severe AD patients. Patients did self-report a preference in using nanotextile over conventional viscose material for WWT.

This study lays the groundwork for further investigation into an alternative material for use with WWT for patients with AD. As a more cost-effective substitute, nanotextiles show promise of being comparable to the previously used viscose in Singapore and less abrasive than the traditionally recommended cotton. Furthermore, improving patient comfort will likely increase compliance. Therefore, studies such as this one should be encouraged and expanded so as to continue to find safe and comfortable alternatives to traditional standards.