ISSN: 2574-7800
Authors: Arifin S*, Indar Widayati R, Riyanto P, Budiastuti A, Adriani Malik D, Muslimin and Hardian
Background: Atopic dermatitis (AD) is a chronic pruritic inflammatory disorder characterized by skin barrier dysfunction. This dysfunction manifests as increased transepidermal water loss (TEWL) and increased penetration of allergens and infectious agents, leading to inflammation and itching. Atopic dermatitis most commonly occurs in children, but can also be found in adults. Dryness and barrier dysfunction in atopic dermatitis are considered to be caused by a decrease in ceramide levels in the stratum corneum. Topical moisturizers, such as ceramide, are considered to be able to solve this problem by acting as a barrier repair agent. Objective: To prove the effectiveness of topical ceramide moisturizer compared to other topical moisturizers against atopic dermatitis. Methods: The result of an electronic database search of Medline, Pubmed, Scopus, EBSCOhost, ProQuest, Google Scholar, Cochrane library, ClinicalTrials.gov, and others found 6 articles included in the qualitative review (n = 270 subjects) and 3 articles (n = 32 subjects) were included in the meta-analysis. Results: Meta-analysis showed that the group of patients with atopic dermatitis who used topical ceramide moisturizer showed a difference in TEWL score before and after treatment, and the mean difference showed a negative value. This suggests that there was a decrease in TEWL scores after using topical ceramides Moisturizer. The control group also had similar mean TEWL score decrease. This suggests that other moisturizers can also reduce TEWL scores in the control group. The largest decrease in TEWL scores was found in Tabri, et al's 2018 study, which showed mean ±SD -24.46+5.53 reduction after using topical ceramides. The lowest decrease in TEWL scores was found in Kircik et al.'s 2014 study using topical petrolatum, which showed mean±SD -2.175±7.43. The result of the heterogeneity test showed the value of p = 0.478, I2 = 0.000. This shows the data is homogeneous, and thus the analysis was carried out using a fixed- effect model. Statistical data obtained showed that topical ceramide moisturizer given to atopic dermatitis (p=0.168) produced no significant results. Conclusions: The results of the meta-analysis were not statistically significant. However, in the ceramide moisturizer group, the overall trend of TEWL score decrease was greater than in the control group. The findings of the qualitative analysis revealed that using a topical ceramide moisturizer may lower the TEWL score and enhance skin barrier function in atopic dermatitis patients and that it had the same effect as other topical moisturizers.
Keywords: Topical ceramide; Atopic dermatitis; Transepidermal water loss
