Clinical dose of topical steroids in the management of atopic dermatitis - A multicenter examination

Topical corticosteroids play an important part in the management of atopic dermatitis (AD). We examined the therapeutic doses of topical steroids for AD patients in 10 dermatological clinics. Twenty-two infantile (<2 years old) AD patients, 74 childhood (2≤ <13 years old) AD patients and 452 adolescents/adult (13 years old ≤) AD patients were enrolled in this study. During the 6 month treatment period the majority of patients (more than 80%) applied topical steroids on the face at a dose of <20g in infantile AD, <30g in the childhood AD and <60g in adolescent/adult AD; on the scalp at a dose of 0g in infantile AD, <30g in the childhood AD and <120g in adolescent/adult AD; and on other sites of the body at a dose of <90g in infantile AD, <180g in the childhood AD and <300g in adolescent/adult AD. In adolescent/adlt AD the incidence of malar teleangiectasia was significantly more frequent in the 60g ≤ application group on the face compared to the <60g application group. Similarly, malar teleangiectasia was observed significantly more often in the 120g ≤ application group on the scalp than in the <120g application group. The incidence of skin atrophy in the elbows and knees was not significantly different between in the <300g application group and in the 300g ≤ application group on other sites of the body except for the face and the scalp. 70.5% of topical steroids applied on the face belonged to the rank of 'very strong' or 'strong' in the severest AD, whereas in the moderate or mild AD the rank was 'medium' and 'weak' in more than 90% of the facial topical steroids.