***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: UVB phototherapy of atopic dermatitis was investigated in two paired‐comparison studies . In study 1 , 17 patients were treated for 8 weeks with ultraviolet B radiation ( UVB ) on one half of the body and with visible light ( placebo ) on the other . A severity score based on eight clinical variables was determined before , during and after treatment . The total score , pruritus score and overall evaluation score were significantly better on the UVB treated sides than on the placebo treated sides ( P < 0.001 ) . In 13 patients the UVB treated side healed or improved considerably , while the placebo treated side improved considerably in one patient only BACKGROUND This report investigates the effect of pimecrolimus cream 1 % ( Elidel , Novartis pharma AG , Basel , Switzerl and ) , a nonsteroid , cell-selective , cytokine inhibitor on the course of atopic dermatitis ( AD ) , as assessed by changes in body surface involvement and pattern of drug use over time . METHODS Data from 961 patients in two 1-year double-blind , multicenter , pediatric studies of similar design were analyzed : 250 infants ( aged 3 - 23 months ) were r and omized 4 : 1 and 711 children ( aged 2 - 17 years ) were r and omized 2 : 1 to receive pimecrolimus cream 1 % or vehicle , respectively . Emollients were used by all patients to alleviate dry skin and , at the first signs or symptoms of AD , pimecrolimus or vehicle was applied twice daily to prevent progression to flares . If flares occurred in either group , moderately potent topical corticosteroids were m and ated . RESULTS Pimecrolimus was applied for 68.4 % ( infants ) and 53.8 % ( children ) of study days , and frequency of use of  pimecrolimus  decreased over time , reflecting improvement in disease control . The mean total body surface area affected decreased continuously over time . Significantly more patients in the pimecrolimus than control groups were maintained without corticosteroid therapy ( infants : 63.7 % vs. 34.8 % , P < 0.001 ; children : 57.4 % vs. 31.6 % , P < 0.001 , respectively ) . CONCLUSION The need for pimecrolimus therapy decreases over time as the patients ' disease improves . Hence , once long-term management of AD with pimecrolimus is established , the burden of disease for both the patient and the caregiver decreases significantly and disease-free periods become more frequent Summary Background Therapeutic options to treat atopic dermatitis are limited . Leukocytes from atopic patients have an abnormally high activity of cyclic adenosine monophosphate (AMP)–phosphodiesterase ( PDE ) , which can be normalized in vitro by PDE inhibitors . Cipamfylline is a new potent and selective inhibitor of PDE‐4 BACKGROUND The skin of patients with atopic dermatitis ( AD ) is heavily colonized with Staphylococcus ( S. ) aureus , even at uninvolved sites . Toxins secreted by the majority of S. aureus on the skin behave as superantigens and can directly influence the disease activity , although clinical signs of bacterial superinfection might be absent . OBJECTIVES This study was conducted to compare the efficacy of hydrocortisone cream , combined with mupirocin or alone with emmolient ointment for the treatment of mild to moderate AD in infants between six months and two years of age . MATERIAL S AND METHODS A total of 83 patients with mild to moderate AD were r and omized to receive hydrocortisone , hydrocortisone+ mupirocin or emmolient ointment twice daily in one week and followed-up for 8 weeks , in a blind study . Efficacy evaluation made by SCORAD and eczema area and severity index ( EASI ) at baseline , day 7 , and weeks 2 , 4 , and 8 . Possible adverse events were recorded to evaluate safety . RESULTS At the end of study , 65 % ( 17 of 26 ) of the patients were treated successfully with  hydrocortisone ointment based on SCORAD and EASI scores . Also there was a significant improvement in patients combined with mupirocin ointment [ 74 % ( 20 of 27 ) ] . The percent improvement from baseline in EASI scores was also significantly greater in hydrocortisone and combined group compared with emmolient-treated patients ( 36 % ) ( p = 0.0187 , p = 0.012 respectively ) . CONCLUSIONS Monotherapy with hydrocortisone ointment is the main treatment in infants with mild to moderate AD and combination with mupirocin is safe and effective often needed because of possible Staphylococcus carriage Etude sur 49 malades ambulatoires , avec placebo . Il semble que l'acrivastine et la terfenadine soient capables de diminuer le prurit , sans effet sedatif indesirable , et qu'ils renforcent l'action des traitements locaux ( corticoides , emollients Background Pruritus is a debilitating aspect of atopic dermatitis ( AD ) .  Acupuncture has been reported to diminish pruritus , but self-administered acupressure has not been previously evaluated . Objectives To evaluate the effectiveness of acupressure on the severity of eczema in a pilot trial . Methods Adult patients with AD were r and omised to an intervention group ( acupressure with st and ard of care ) or a control group ( st and ard of care alone ) . Subjects in the intervention group performed acupressure using a 1.2 mm acupellet at the LI11 point , applying pressure for 3 min three times per week for 4 weeks . The severity of itching and AD at baseline and at 4 weeks were measured on a visual analogue scale ( VAS ) , the Investigator 's Global Assessment ( IGA ) and the Eczema Area and Severity Index ( EASI ) . Results Fifteen subjects were enrolled , 12 of whom completed the study between November 2009 and May 2011 . There was no significant change between baseline and follow-up survey scores within the control group . In the investigation group there was a decrease in the VAS score ( p=0.05 ) and EASI lichenification ( p=0.03 ) , although without significant change in the overall EASI score . Comparison of the scores between groups showed a greater decrease in VAS in the experimental group than in the control group ( p=0.04 ) , and a decrease in the IGA ( p=0.03 ) and EASI lichenification score ( p=0.03 ) . The overall EASI scores were unchanged . Conclusion Subjects using acupressure at LI11 for 4 weeks had improvement in pruritus and lichenification . Acupressure may prove to be an easily administered alternative treatment , but larger-scale studies are needed to confirm these preliminary findings BACKGROUND Atopic eczema affects 1 - 2 % of adults , and can cause considerable morbidity . We aim ed to assess the safety and efficacy of azathioprine as systemic monotherapy for moderate-to-severe atopic eczema , and the therapeutic importance of the thiopurine methyltransferase ( TPMT ) polymorphism ( a key determinant of azathioprine-induced myelotoxicity ) by using TPMT enzyme activity to establish azathioprine dose . METHODS We did a parallel-group , double-blind , placebo-controlled trial in an outpatient setting . Minimisation was used to assign 63 patients with active disease despite optimum topical therapy to treatment with azathioprine  ( n=42 ) or placebo ( n=21 ) for 12 weeks . As maintenance treatment , patients with heterozygous range TPMT activity received azathioprine 1.0 mg/kg daily , compared with 2.5 mg/kg daily in patients with normal TPMT activity . For the first 4 weeks , all participants received lower azathioprine doses ( 0.5 and 1.0 mg/kg daily , respectively ) to reduce gastrointestinal side-effects . The primary measure of clinical response was disease activity assessed by the SASSAD ( six area six sign atopic dermatitis ) score . Analysis was by intention-to-treat . This study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N58943280 . FINDINGS 54 ( 86 % ) participants completed the study ; two ( 3 % ) withdrew from the placebo group and seven ( 11 % ) from the azathioprine group . At week 12 , there was a 37 % ( 12.0 unit ) improvement in mean disease activity with azathioprine compared with a 20 % ( 6.6 unit ) improvement with placebo ( 17 % [ 5.4 unit ] difference , 95 % CI 4.3 - 29 % ) . This finding was accompanied by significant improvements in patient-reported itch , area of involvement , global assessment , and quality of life . Between participants there was a wide variation in response to the drug . Generally , azathioprine was well tolerated , although two individuals developed drug hypersensitivity . Participants with heterozygous range TPMT activity responded to azathioprine in similar proportions to other participants , but none developed bone-marrow toxicity . TPMT-based dosing seemed to reduce predicted toxicity , and drug efficacy was maintained . INTERPRETATION Treatment with azathioprine as systemic monotherapy produces clinical ly relevant improvement in moderate-to-severe atopic eczema that remains active despite optimum therapy with topical corticosteriods . We believe the study of azathioprine as systemic monotherapy for atopic eczema has major advantages , which should allow clarification of the relation between  azathioprine effectiveness and metabolite profiles in other inflammatory diseases Abstract Objective To explore the efficacy and safety of fluticasone propionate , cream and ointment , applied twice weekly in addition to maintenance treatment with emollients , in reducing the risk of relapse of  chronic recurrent atopic dermatitis .  Design R and omised , double blind , parallel group study of 20 weeks ' duration . Setting Dermatology outpatient clinics ( 6 countries , 39 centres ) . Participants Adult ( aged 12 - 65 ) patients with moderate to severe atopic dermatitis who were experiencing a flare . Methods Participants applied fluticasone propionate ( 0.05 % cream or 0.005 % ointment ; once or twice daily ) regularly for four weeks to stabilise their condition . The patients whose disease was brought under control then continued into a 16 week maintenance phase , applying emollient on a daily basis with a bath oil as needed and either the same formulation of fluticasone propionate or its placebo base ( emollient alone ) twice weekly to the areas that were usually affected . Main outcome measure Time to relapse of atopic dermatitis during maintenance phase . Results 376 patients entered the stabilisation phase , and 295 continued into the maintenance phase . After 16 weeks in the maintenance phase , the disease remained under control in 133 patients ( 87 using fluticasone propionate twice weekly , 46 using emollient alone ) , 135 ( 40 fluticasone propionate , 95 emollient ) had experienced a relapse , and 27 had discontinued . Median time to relapse was six weeks for emollient alone compared with more than 16 weeks for additional fluticasone propionate . Patients who applied fluticasone propionate cream twice weekly were 5.8 times less likely ( 95 % confidence interval 3.1 to 10.8 , P < 0.001 ) and patients using fluticasone propionate ointment 1.9 times less likely ( 1.2 to 3.2 , P=0.010 ) to have a relapse than patients applying emollient alone . The groups showed no differences in adverse events . Conclusion After atopic dermatitis had been stabilised the addition of fluticasone propionate twice weekly to maintenance treatment with emollients significantly reduced the risk of relapse Hydrocortisone valerate cream ( 0.2 percent ) was evaluated in three controlled clinical trials involving a total of sixty-eight patients with atopic dermatitis . This new nonfluorinated steroid was found to be as effective as the fluorinated beta-methasone valerate cream ( 0.1 percent ) and significantly more effective than hydrocortisone cream ( 0.1 percent ) and the placebo cream base . All studies were double-blind , paired comparisons , utilizing application of the medications three times a day for up to four weeks or until clearing occurred BACKGROUND Intermittent dosing of a topical calcineurin inhibitor for preventing atopic dermatitis ( AD ) disease relapse in patients with stabilized AD has not been evaluated . OBJECTIVE We sought to evaluate the long-term efficacy and safety of 3-times-weekly use of tacrolimus ointment in preventing AD disease relapse . METHODS Adult and pediatric patients with moderate to severe AD who were clear of disease after up to 16 weeks of treatment with tacrolimus ointment were r and omized in a double-blind fashion to 3-times-weekly treatment with either tacrolimus ointment ( 0.03 % or 0.1 % ) or vehicle for 40 weeks . The primary end point was the number of flare-free treatment days . RESULTS A total of 125 patients were r and omized to tacrolimus  and 72 patients to vehicle .  The mean number of flare-free treatment days was 177 for tac 
    Output:
    
Interventions with reasonable evidence of ' no benefit ' included some dietary interventions , ion exchange water softeners , multiple daily applications of topical corticosteroids and antibiotic-containing corticosteroids for noninfected AE .