Efficacy

We found no systematic review, but found three RCTs evaluating clothing material in atopic eczema.34-36 Diepgen et al. in 199031 and 1995,32

evaluated the irritative capacity of shirts made of four different materials (cotton and synthetics of different fibre structure). The other RCT by Seymour et al.36 evaluated the clinical effects of different types of nappies on the skin of normal infants and infants with atopic eczema.

In the 1990 study by Diepgen et al.,34 55 patients with atopic eczema were compared with 31 control patients without atopic eczema and were randomised to wear shirts of one of four different types of fibre. At the end of week 2 of the study those wearing cotton shirts reported better comfort compared with the other textile shirts in increasing order of weight and fibre roughness.

The 1995 study by Diepgen et al.35 (published in a German textile journal) evaluated seven different garments on 20 patients with mild-to-moderate atopic eczema. The garments were either cotton or polyester, with different fibre roughness, yarn roughness and fabric weaves. The study was a randomised crossover study (Diepgen T, personal communication, January 2000), with each garment worn under standardised conditions on four consecutive days. Comfort was statistically significantly higher for warp-knit shirts compared with jersey-knit shirts, but was no different for cotton and polyester of fine fibre construction (assessed by scanning electron microscopy).

In the Seymour et al. study,36 cloth nappies were compared with cellulose-core nappies and cellulose-core nappies containing absorbent gelling material. Eighty-five babies with atopic eczema who were less than 20 months of age were recruited. Eczema severity and degree of nappy rash were scored by an independent dermatologist. At the end of the 26-week period, there was no clinical or statistical difference between the different nappy types for overall grade of atopic eczema. However, nappy rash was significantly less in the group using cellulose nappies with absorbent gelling material

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