Emollient enhancement of the

skin barrier from birth offers

effective atopic dermatitis
prevention
Tirta Yudha SHP
11711063 /14712202

Resume Jurnal
Tujuan

Metode

Menguji efek
dari emolien
pada
pemberian
lebih dini
untuk
pencegahan
dermatitis
atopi pada
kelompok
yang
beresiko

RCT
Pilot Study
Pada anak
dengan usia
maks 3
minggu yang
beresiko
Selama 6
bulan
Multicenter
Multinasional

Hasil
Efek
Pencegahan

Kesimpulan
Emolien
pada
pemakaian
lebih dini
secara
teratur dapat
membantu
mencegah
dermatitis
atopi pada
kelompok
beresiko

Pendahuluan

Metode

Blinding
orang tua tidak blind
Asisten penilai independen di blind
Statistika juga di blind untuk kelompok treatment
sampai analisis dari penelitian komplit.

Sampel
Penelitian Pilot
Besar sampel diserahkan pada waktu dan sumber yang
ada

Hasil

Hasil

Pembahasan
Morbiditas dari dermatitis atopi dan meningkatnya
prevalensi dan potensi keracunan pada terapi
imonosuppressant saat ini membuat pencegahan
penyakit sebagai tujuan yang sangat penting.
emolien memperbaiki disfungsi barrier kulit subklinis
dan inflamasi awal pada bayi yang beresiko sebelum
dermatitis atopi berkembang dengan menambahkan
hidrasi kulit dan mengurangi permeabilitas kulit.
Perbaikan barrier kulit ini mencegah kekeringan dan
keretakan kulit, dan juga mencegah zat iritan dan
allergen masuk kedalam epidermis, yang merupakan
inisiator potensial pada inflamasi di kulit.

Pembahasan
Emolien meningkatkan fungsi barrier kulit, bebas dari
iritan dan alergen berpotensi dan murah serta mudah
umtuk digunakan sehingga intervensi ini bisa digunakan
diseluruh dunia. Masih

Kelebihan dan kekurangan

PICO

Apakah hasil Penelitian Valid

1.

Apakah

pasien

penelitian
Apakah

yang

ikut

Ya

dirandomisasi?
sistem

tersembunyi ?

acaknya Halaman 819 Blinding paragraf 1

It was not possible to blind parents in a
trial of daily emollient application. An
independent outcome assessor who was
blinded to treatment allocation performed
the skin examinations and diagnosis of
eczema.

This

was

practitioner,
dermatology
statistician

usually

general

dermatologist,
nurse
was

specialist.

blinded

to

or
The

treatment

group until the analysis was complete.

2. Apakah follow-up pasiennya cukup panjang Pasien tidak difollow up panjang tapi cukup lengkap.
dan lengkap?

Halaman 819 Visit Schedule and Randomization Paragraf 1

Participation in the trial was for 6 months duration.
Halaman 822 Discussion Paragraf 4
The major limitation of this study was the short follow-up
time and small number of participants.

Halaman 819 Visit Schedule and Randomization Paragraf 3

The research nurse contacted parents by telephone at 10
days and 6 weeks, with a face-to-face visit at 12 weeks
(usually at home in the United Kingdom and as a clinic visit
in the United States). This was then followed by a further
telephone call at 18 weeks, and the final contact was a
clinic

visit

at

dermatologist

24
or

weeks

for

dermatology

an

assessment

specialist

by

nurse,

the
who

conducted a blinded assessment of the skin. In addition to

these scheduled contact points, parents were encouraged
to contact the research nurse if they had any concerns
about the childs skin. If parents reported symptoms of
eczema, then an unscheduled visit to the hospital to see

3.

Apakah

dalam

pasien

grup

dirandomisasi?

di

yang

analisis Ya
telah
Halaman 820 Results, Feasibility End
Points Paragraf 1
A total of 430 families were identified,
of which 135 (31%) were not eligible. Of
the

295

accepted

eligible
the

families,
initial

124

(42%)

invitation

to

participate and were randomized (see

the CONSORT flow diagram, Fig 2).

4. Apakah pasien dan peneliti tetap Orang tuanya pasien tidak tapi peneliti iya
dibuat
terapi?

blind"

dalam

pelaksanaan
Halaman 819 Visit Schedule and Randomization
Paragraf 3
The

research

nurse

contacted

parents

by

telephone at 10 days and 6 weeks, with a face-toface visit at 12 weeks (usually at home in the
United Kingdom and as a clinic visit in the United
States).

This was then

followed by a further

telephone call at 18 weeks, and the final contact

was a clinic visit at 24 weeks for an assessment by
the dermatologist or dermatology specialist nurse,
who conducted a blinded assessment of the skin. In
addition to these scheduled contact points, parents
were encouraged to contact the research nurse if
they had any concerns about the childs skin. If
parents reported symptoms of eczema, then an
unscheduled

visit

to

the

hospital

to

see

the

5.

Apakah

diperlakukan

setiap
dengan

grup Ya

seimbang,

diluar dari perlakuan eksperimen? Halaman 819 Intervention Paragraf 2

Both the intervention and control groups
were given
booklet,

an

infant

which

skin

care

reflected

advice
current

guidelines.25 Parents are advised (1) to

avoid soap and bubble bath; (2) use amild,
fragrance-free synthetic cleanser designed
specifically for babies; (3) avoid bath oils
and additives; (4) use a mild, fragrancefree

shampoo

designed

specifically

for

babies and avoid washing the suds over the

babys body; and (5) avoid using baby
wipes, where possible

6. Apakah setiap grup Ya

serupa

pada

percobaan?

awal
Halaman

819

Participants

Paragraf 1
Infants at high risk of eczema,
which was defined as having a
parent or full sibling who has
(or

had)

physician-diagnosed

atopic dermatitis, asthma, or

allergic rhinitis, were included

Apakah

hasil

valid

dari

penelitian

yang

randomisasi

ini

cukup

penting ?
1. Berapa besar efek terapi Cukup baik dan signifikan untuk mencegah
yang dapat ditimbulkan ?

terjadinya dermatitis atopi

Halaman 821 clinical end points Paragraf 1

Daily emollient use significantly reduced
the

cumulative

incidence

of

atopic

dermatitis at 6 months (43% in the control

group vs 22% in the emollient group). This
corresponds to a relative risk reduction of
50% (relative risk, 0.50; 95% CI, 0.28-0.90;
P5.017).

2. Berapa tepat estimasi hasil Cukup

terapi yang ditimbulkan ?

tepat

dan

signifikan

untuk

mencegah terjadinya dermatitis atopi

Halaman 821 clinical end points Paragraf 1

Daily emollient use significantly reduced
the

cumulative

incidence

of

atopic

dermatitis at 6 months (43% in the control

group vs 22% in the emollient group). This
corresponds to a relative risk reduction of
50% (relative risk, 0.50; 95% CI, 0.28-0.90;
P5.017).

Apakah

hasilnya

valid?

Apakah

hasilnya

penting

dan

dapat

diaplikasikan pada pasien kita?

1. Apakah pasien kita cukup Tidak karena penelitian ini dilakukan di dua
berbeda dengan pasien pada negara
penelitian

sehingga

penelitian

tidak

diaplikasikan ?

dan

beberapa

center

sehingga

hasil cukup mewakili dunia.

dapat
Halaman 822 Discussion Paragraf 4
The strengths of our study include the
randomized controlled trial design, blinded
outcome assessment, and potential external
validity of studying the intervention in 2
countries and several centers

2.

Apakah Ya

terapi

dapat Halaman 822 Discussion paragraf 3

dilakukan pada Emollients should improve skin barrier function,

keadaan pasien be free of irritants and potential allergens, and be low cost and easy to use
kita?
3.

so that the intervention can be used worldwide.

Apakah Keuntungannya emolien merupakan zat yang relative aman hampir ke seluruh orang

keuntungan
dan

bahkan pada bayi dan terbukti pada jurnal ini hasilnya signifikan dalam pencegahan

kerugian dermatitis atopi pada bayi dengan usia maksimal 3 minggu

yang
oleh
kita

yang memiliki faktor

dimiliki resiko tinggi terkena dermatitis atopi

pasien Halaman 822 Clinical End Points paragraf 1
jika Three superficial cutaneous infections occurred in each group, all of which were

melaksanakan

considered mild in nature. There were no reports of irritant or allergic

terapi?

contact dermatitis.
Halaman 822 Discussion paragraf 3
Emollients should improve skin barrier function, be free of irritants and potential
allergens, and be low cost and easy to use so that the intervention can be used
worldwide.

4.

Apa

yang

pasien Intervensi yang dilakukan pada

harapkan dan perkirakan pasien

untuk hasil terapi yang hasil
sedang
hasil

dilakukan

terapi

yang

kita tawarkan?

sangat
yang

aman

sehingga

diharapkan

adalah

dan tidak munculnya dermatitis atopi

akan pada bayi yang beresiko.

Halaman 820 Results, Feasibility

End Points Paragraf 1
All parents reported they found
the emollient acceptable, and
none of the families withdrew
because of the emollient.