A prospective study of atopic dermatitis managed without topical corticosteroids for a 6-month period

Abstract

Topical corticosteroids (TCS) are regarded as the mainstay treatment for atopic dermatitis (AD). As AD has a tendency to heal naturally, the long-term efficacy of TCS in AD management should be compared with the outcomes seen in patients with AD not using TCS. However, there are few long-term studies that consider patients with AD not using TCS. We designed a prospective multicenter cohort study to assess the clinical outcomes in patients with AD who did not use TCS for 6 months and then compared our results with an earlier study by Furue et al which considered AD patients using TCS over 6 months. Our patients' clinical improvement was comparable with the patients described in Furue's research. In light of this, it is reasonable for physicians to manage AD patients who decline TCS, as the expected long-term prognosis is similar whether they use TCS or not.

Keywords: atopic dermatitis; topical corticosteroids; topical steroid addiction.

Figure 1

The results of our study (A) and the previous study by Furue et al (B) Notes: The yellow shading is the uncontrolled group defined by Furue et al. The red outline indicates the no improvement group. Abbreviation: AD, atopic dermatitis.

Figure 2

An infant with moderately severe atopic dermatitis (left). Note: The patient did not use TCS and 4 months later was assessed as being in remission. Abbreviation: TCS, topical corticosteroids.