Systemic corticosteroids discouraged for atopic dermatitis

(HealthDay)—Routine use of systemic corticosteroids is generally discouraged for atopic dermatitis, according to research published online Sept. 2 in the British Journal of Dermatology.

Aaron M. Drucker, M.D., Sc.M., from Alpert Medical School of Brown University in Providence, R.I., and colleagues address the use of systemic corticosteroids for atopic dermatitis. The International Eczema Council (IEC) was surveyed with a series of statements accompanied by visual analogue scales ranging from strongly disagree to neutral to strongly agree; 60 of 77 IEC members participated.

The researchers note that consensus was reached on 12 statements, including that systemic corticosteroids should be avoided generally. In specific circumstances, systemic corticosteroids can be used rarely for severe atopic dermatitis, such as lack of other treatment options, as a bridge to other systemic therapies or phototherapy, during acute flares that need immediate relief, in anticipation of a major life event, or in the most severe cases. Treatment should be limited to short term, if used. Although most respondents agreed that systemic corticosteroids should never be used in children, consensus was not reached. A dearth of high-quality published evidence limited the conclusions of the expert group. Consensus would have been reached on fewer statements if more stringent consensus criteria were applied.

"Based on expert opinion from the IEC, routine use of systemic corticosteroids for atopic dermatitis is generally discouraged and should be reserved for special circumstances," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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