Short‐term growth and bone turnover in children undergoing occlusive steroid (‘Wet‐Wrap’) dressings for treatment of atopic eczema

Abstract

To assess the effects of steroid wet‐wrap therapy on short‐term growth and bone turnover, eight prepubertal (M:F,5:3) children with a median age of 5.1years (range 3.3–8.8) were studied over a 2‐week period prior to therapy and at 2‐week intervals during therapy. Short‐term growth was assessed by measuring lower leg length velocity (LLLV) by knemometry and bone and collagen turnover was assessed by urinary deoxypyridinoline crosslink excretion corrected for creatinine excretion (DPD).Median duration of study during occlusive dressings was 12 weeks (range 2–18). Topical beclomethasone dipropionate diluted 1:10 or 1:4 in white soft paraffin was applied under tubular (Tubifast®) bandages in 7/8 children. Median LLLV before and during therapy were 0.43 mm/week (10th,90th centile; 0.0,0.7) and 0.42 mm/week (10th,90th centile; −0.35,1.01), respectively (not significant). Median DPD before and during therapy were 25.9 nmol/l/creatinine (10th,90th centile; 20.8, 33.0) and 26.3 nmol/l/creatinine (10th,90th centile; 21.7, 34.1) respectively (not significant).Non‐invasive assessment of the effects of steroid wet‐wrap therapy can be performed in children with eczema. These preliminary results show no substantial growth promoting or adverse effects of therapy.