Direct Observed "Soak and Smear" Therapy for Severe Eczematous Dermatitis in the Combat Setting

Background: Eczematous dermatitis is difficult to control in a combat setting and may result in a service member's early return to the United States. We report on seven patients with presumed eczematous dermatitis for whom traditional treatments had failed. Objective: To evaluate the effectiveness of "soak and smear" in eczematous dermatitis. Method: The patients were treated with 3 days of direct observed soak and smear therapy with topical steroids. Results: All seven patients significantly improved with treatment, showing a decrease in investigator global assessment, patient self-assessment, and pruritus scores. Conclusion: This study demonstrates that direct observed soak and smear therapy is an effective tool with which to rapidly improve severe eczema. Additionally, this method can be used in the combat environment.