***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Hydration with topical emollients forms the backbone of treatment for mild atopic dermatitis ( AD ) , but few r and omized controlled trials have assessed their efficacy in young children . OBJECTIVES Assess the efficacy and tolerability of long-term emollient therapy in the treatment of moderate to severe xerosis in young children with AD . METHODS This was a phase III , multicentre , double-blind , r and omized , vehicle-controlled trial . Children ( n = 251 ) aged 2 - 6 years with AD-associated xerosis were r and omized 1 : 1 to a 28-day treatment with an emollient combining glycerol and paraffin or its vehicle . Non-responders at the end of the double-blind period were treated open label with emollient until day 84 . Responders stopped treatment until re assessment on day 56 . Those who relapsed after stopping treatment were treated open label with emollient until day 84 . RESULTS During the double-blind period , xerosis score ( XS ) of the scoring atopic dermatitis ( SCORAD ) index , objective SCORAD and visual analogue score decreased and skin hydration increased more in the emollient group than in the vehicle group ( P < 0.001 for all measures ) . More patients were responders with emollient than with vehicle ( 66.1 % vs. 45.6 % , P < 0.001 ) . During the open-label period , stopping emollient treatment led to relapse but improvement returned if treatment was restarted with emollient . Regular use of the emollient also yielded improvement in children who did not initially respond . Adverse events were similar in the two groups , and no treatment-related severe adverse events were reported . CONCLUSIONS Long-term therapy with emollient is effective and well tolerated for the treatment of xerosis in children with atopic dermatitis Background : Atopic dermatitis ( AD ) is characterized by barrier abnormalities , including insufficient ceramides in the stratum corneum ( SC ) . Objective : To measure the effects of a new moisturizer ( CRM ) containing a ceramide precursor in improving skin barrier function in patients with controlled atopic dermatitis . Methods : In this r and omized , intra-individual comparison , investigator-blinded study , CRM was applied to the test area of one lower leg for 27 days ( the other leg remained as untreated control ) . Evaluations at baseline and day 28 included transepidermal water loss ( TEWL ) , skin hydration by corneometry , dryness severity , Raman spectroscopy , and collection of adverse events . Results : After 4 weeks of treatment , results showed a significantly greater reduction of TEWL and clinical dryness scores , and increased skin hydration ( all p < 01 ) in the CRM-treated than untreated area . A significantly higher level of ceramide ( p < 05 ) and a trend toward increased water content was observed with Raman in the SC for CRM than for the control . There were no related AEs . Conclusion : Skin barrier function and hydration were significantly improved after CRM treatment New treatment modalities are needed in atopic dermatitis . We evaluated the pharmacokinetics , safety , tolerability , and efficacy of topical cis-urocanic acid ( cis-UCA ) cream in r and omised vehicle-controlled double-blinded clinical trials . The subjects received 5 % cis-UCA emulsion cream and control vehicle on volar forearms after right-left r and omisation . Study 1 : 16 healthy subjects received one dose on the skin and , a week later , on DMSO-irritated skin . Study 2 : 16 healthy subjects received 2 daily doses for 10 days . Study 3 : 13 patients with mild to moderate disease were treated on selected skin lesions twice daily for 28 days . Study treatments were well tolerated . cis-UCA remained close to endogenous levels in plasma and urine . cis-UCA reduced transepidermal water loss ( TEWL ) both in healthy subjects and in the patients .  Eczema area severity index and physician 's global assessment improved from baseline with both treatments . cis-UCA cream improved skin barrier function and suppressed inflammation in the human skin Patients with atopic dermatitis ( AD ) have an epidermal barrier dysfunction , which allows invasion of allergens to occur . Stratum corneum skin barrier is formed by corneocytes and extracellular lipids extruded from the epidermal lamellar bodies . In a controlled , r and omized , double-blinded , right-left comparison study we investigated the effect of pimecrolimus ( PIM ) cream compared with triamcinolone acetonide cream ( TA ) on the skin barrier in 15 patients with symmetrical elbow lesions of AD . In punch biopsies , before and after treatment , skin lipid bilayer and lamellar body structure were examined by transmission electron microscopy ( TEM ) . Partial Eczema Area and Severity Index ( pEASi ) , stratum corneum hydration , and transepidermal water loss ( TEWL ) were monitored on days 1 , 8 and 22 . The pEASi was significantly more improved with TA compared with PIM , whereas stratum corneum hydration was slightly more improved after treatment with PIM . The TEM revealed a strong reduction in lamellar bodies in lesional skin of AD ; only 32 % of the lamellar bodies were normal . A significantly higher number of normal lamellar bodies was found after 3 weeks of treatment with PIM ( 58 % ; p < 0.005 ) . An increase in lamellar bodies also occurred with TA treatment ( 46 % ; p < 0.05 ) ; however , significantly less than with PIM ( p < 0.05 ) . Clinical score and TEWL were more improved after treatment with TA , whereas the lamellar bodies were more normal after treatment with PIM Background : Pruritus ani ( PA ) is defined as intense chronic itching affecting perianal skin . Objective : We aim ed to determine the efficacy of topical tacrolimus treatment in atopic dermatitis ( AD ) patients who have PA . Methods : The study included 32 patients with AD who were suffering PA . Patients were r and omized into two groups . In total , 16 patients used 0.03 % tacrolimus ointment and 16 patients used vaseline as placebo . All groups applied topical treatments to their perianal area twice daily for 4 weeks . The treatments were then reversed for 4 weeks after a 2 weeks wash out period . Results : In total , 32 patients with AD who had refractory anal itching were enrolled in this study . None of the patients had obtained successful results with previous treatments . There was a statistically significant decrease in the recorded EASI , DLQI and itching scores for the tacrolimus group compared to the placebo group at weeks 4 and 6 of treatment ( p < 0.05 ) . Conclusion : Topical tacrolimus treatment was well tolerated and effective in controlling persistent PA in AD patients Background : No study has clearly demonstrated the steroid-sparing effect of emollients in the treatment of atopic dermatitis ( AD ) . Aim : Evaluating the effect of an emollient containing oat extracts on the amount of topical corticosteroids used in infants with moderate to severe AD . Study Design : During 6 weeks , 173 infants under 12 months old treated for inflammatory lesions by moderate- and /or high-potency topical corticosteroids r and omly received the emollient or not ( control group ) . Methods : Evaluation of  corticosteroid consumption by weighing the tubes , disease severity by the Scoring Atopic Dermatitis Index ( SCORAD ) , and infants ’ and parents ’ quality of life by Infant ’s Dermatitis Quality of Life Index and Dermatitis Family Impact scores at D0 , D21 and D42 . Results : Compared to the control group , the amount of moderate- and high-potency corticosteroids used in 6 weeks decreased by 7.5 % ( not significant ) and 42 % ( p < 0.05 ) , respectively , in the emollient group . The SCORAD index , and infants ’ and parents ’ quality of life significantly improved ( p < 0.0001 ) in both groups . Conclusion : The emollient treatment significantly reduced the high-potency topical corticosteroid consumption in infants with AD Parental education is important in managing childhood atopic dermatitis ( AD ) . We evaluated the long-term effects of a 2-day parental education program ( PEP ) on childhood AD . In an investigator-blinded , r and omized controlled trial , 59 children age 6 months to 6 years with moderate to severe AD and their mothers were recruited in Japan . Participants were given a booklet about AD and received conventional treatment alone or in combination with a 2-day PEP comprising three lectures , three practical sessions , and a group discussion . The primary outcome was evaluation of eczema severity using SCORing Atopic Dermatitis ( SCORAD ) at 6 months . Secondary outcomes included changes in symptom scores , amount of corticosteroid used , parental quality of life as determined according to the Dermatitis Family Impact question naire , and change in parental anxiety regarding the use of corticosteroids in their children .  Participants in the PEP group had a significantly lower SCORAD score than those in the control group at 6 months ( mean difference 10.0 , 95 % confidence interval [ CI ] = 2.3 - 17.7 , p = 0.01 ) and objective SCORAD score ( mean difference 7.1 , 95 % CI = 0.8 - 13.5 , p = 0.03 ) . The sleeplessness symptom score ( mean difference 1.6 , 95 % CI = 0.0 - 3.1 , p = 0.048 ) and corticosteroid anxiety score ( p = 0.02 ) in the PEP group were significantly better than in the control group at 6 months . There was no significant difference between groups in the amount of corticosteroid used or quality of life . The PEP had positive long-term effects on eczema severity and parental anxiety about corticosteroid usage Abstract Background : Atopic dermatitis ( AD ) is a disease with multifactorial etiology . Staphylococcus aureus is one of the predominant environmental factors acting on the course and intensity of the disease . Objectives : The aims of the study were to evaluate the efficacy and safety of clothing made of cellulose fibers with seaweed enriched with silver ions in the treatment of children with AD . Methods : A prospect i ve , r and omized and double-blinded controlled selection was done to recruit 19 children with diagnosis of AD . This sample was divided in two groups with similar demographic and clinical characteristics ( the “ control ” group of seven children  who wore placebo clothing and the “ trial textile ” group of 12 children who wore clothing with the new textile ) . The severity of AD and clinical response were assessed by the SCORAD index , the intensity of pruritus and the changes in sleep characteristics , at the start of the study and after 7 and 90 d. Results : The SCORAD index improvement in the group with the fiber under study was statistically significant after the first 7 d of treatment ( p < 0.001 ) and was reduced by about 45 % after 90 d. There was also a statistically relevant reduction of the intensity of pruritus and an improvement in the sleep quality after the initial 7 d and at day 90 . Conclusion : The results showed that the textile clothing with seaweed enriched with silver ions brings a quicker improvement of the patients in the first days in opposition to the use of st and ard all-cotton clothes . The results also reinforce the importance of non-pharmacological measures , like clothing , in the management of patients with a diagnosis of AD Introduction : The natural cyclic tetrahydropyrimidine , ectoine , is a low-molecular , water-binding , organic osmolyte . Previously , topical application of ectoine to healthy human skin was shown to improve skin hydration as well as skin barrier function . Objectives : We therefore speculated that topical application of ectoine would be beneficial for patients with atopic dermatitis ( AD ) , in which a genetically defined defect in skin barrier function is of major pathogenetic relevance . We assessed the efficacy of an ectoine-containing cream ( EHK02 - 01 ) in the management of 65 patients with mild to moderate AD in a r and omized , intra-individual , double-blind , multi-center trial , in which the efficacy of ectoine was compared to a nonsteroidal anti-inflammatory cream previously found to primarily act on skin barrier function and therefore with a comparable mode of action . Methods : Sixty-five patients with mild to moderate AD aged 18 - 65 years were enrolled . The patients applied EHK02 - 01 and the control cream on two symmetrical lesions twice daily for 28 days . At the beginning , after 7 and after 28 days , treated skin areas were assessed by modified , objective local SCORAD ( Scoring Atopic Dermatitis ) and IGA ( Investigator 's Global Assessment ) as well as the patients ' judgment of efficacy and their assessment of pruritus . Results : EHK02 - 01 was found to be very well tolerated . Even more important , efficacy of EHK02 - 01 treatment was equivalent to that achieved with the reference product . Conclusion : These results indicate that topical treatment with EHK02 - 01 may represent a novel option for the treatment of patients with AD Natural oils are advocated and used throughout the world as part of neonatal skin care , but there is an absence of evidence to support this practice . The goal of the current study was to ascertain the effect of olive oil and sunflower seed oil on the biophys 
    Output:
    
Studies on the topical treatment of atopic dermatitis largely supported the recommended use of topical corticosteroids and topical calcineurin inhibitors .
Lipoxin A4 , an eicosanoid with anti-inflammatory properties , and a 5 % cis-urocanic acid emulsion cream were effective in the treatment of atopic dermatitis , although studies were small .
Adjunct therapy with bleach baths , natural oils , and textiles all showed some benefit ; however , studies are limited .
SUMMARY There is strong evidence for the use of topical anti-inflammatory therapies in the treatment of atopic dermatitis .
There is little evidence to suggest that one emollient is better than others