Acta Dermato-Venereologica

<jats:p>Topical steroid withdrawal (TSW) is described as an adverse reaction to topical glucocorticoids (TGCs). A pathophysiological mechanism has not been identified. There are no diagnostic criteria. The aim was to describe patient-reported characteristics of TSW in atopic dermatitis (AD). An observational cross-sectional study was performed by posting a questionnaire for participants, aged ≥18 years, reporting both AD and TSW, in a Swedish TSW-themed Facebook group during 4 weeks in 2023. The questionnaire was accessed by 98 participants, with 82 completing it. Most were female (95%), 18–39 years old (74%), self-diagnosed with TSW (84%), and reported current symptoms of AD and TSW. They defined TSW as dependency on TGCs and adverse reactions to their use. Erythema, desquamation, dryness, and oozing affecting the face, neck, and upper extremities were the most reported signs. Pruritus, sleep disturbance, and signs of anxiety and depression were the most reported symptoms. Recurring episodes of manifestations attributed to TSW were reported by 60%. The personal trigger factor was believed to be TGCs by 93%, and 33% also identified oral glucocorticoids. TGCs were currently used by 21%. Self-reported manifestations of TSW are similar to those of AD but appeared to be distinguishable for the participants and caused considerable morbidity.</jats:p>

Topical steroid withdrawal (TSW) is described as an adverse reaction to topical glucocorticoids (TGCs). A pathophysiological mechanism has not been identified. There are no diagnostic criteria. The aim was to describe patient-reported characteristics of TSW in atopic dermatitis (AD). An observational cross-sectional study was performed by posting a questionnaire for participants, aged ≥18 years, reporting both AD and TSW, in a Swedish TSW-themed Facebook group during 4 weeks in 2023. The questionnaire was accessed by 98 participants, with 82 completing it. Most were female (95%), 18-39 years old (74%), self-diagnosed with TSW (84%), and reported current symptoms of AD and TSW. They defined TSW as dependency on TGCs and adverse reactions to their use. Erythema, desquamation, dryness, and oozing affecting the face, neck, and upper extremities were the most reported signs. Pruritus, sleep disturbance, and signs of anxiety and depression were the most reported symptoms. Recurring episodes of manifestations attributed to TSW were reported by 60%. The personal trigger factor was believed to be TGCs by 93%, and 33% also identified oral glucocorticoids. TGCs were currently used by 21%. Self-reported manifestations of TSW are similar to those of AD but appeared to be distinguishable for the participants and caused considerable morbidity.

Topical Steroid Withdrawal in Atopic Dermatitis: Patient-reported Characterization from a Swedish Social Media Questionnaire.

Topical Steroid Withdrawal in Atopic Dermatitis: Patient-reported Characterization from a Swedish Social Media Questionnaire

Journal of the European Academy of Dermatology and Venereology

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Connections between long‐term use of topical corticosteroids (TCSs) of varying potency and osteoporosis and major osteoporotic fracture (MOF) are unclear. Susceptibility to adverse bone effects of TCSs in different sex, age and ethnic groups is unknown too.</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>To demonstrate the association between cumulative dose of TCSs of varying potency and osteoporosis and MOF in Taiwanese population, with stratified analysis of sex and age.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We conducted a nationwide case–control study and obtained data from Taiwan National Health Insurance Research Database. Cumulative TCS doses in different exposure periods were calculated, and the potency of TCSs was converted to prednisolone equivalent. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for osteoporosis and MOF associated with TCS use.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>From 2017 to 2020, 129,682 osteoporosis cases and 34,999 MOF cases were selected and randomly matched with 518,728 and 139,996 controls by sex and age. We found clear dose–response relationships between long‐term TCS exposure and osteoporosis and MOF. For example, compared to no TCS use, adjusted ORs of osteoporosis were 1.216 (95% CI 1.189–1.243), 1.260 (95% CI, 1.241–1.280) and 1.341 (95% CI, 1.314–1.369) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Adjusted ORs of MOF were 1.118 (95% CI 1.069–1.170), 1.191 (95% CI, 1.156–1.227) and 1.288 (95% CI, 1.238–1.340) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Stratified analysis showed women had higher ORs of osteoporosis and MOF compared to men. Younger people (&lt;50 years) had highest OR of osteoporosis compared to other age groups.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Higher cumulative TCS dose was associated with increased risk of osteoporosis and MOF. Long‐term use of TCSs should be cautious, especially in susceptible populations such as women and young people.</jats:p></jats:sec>

publication_history

received

accepted

published

Secular trends in incidence of osteoporosis in Taiwan: a nationwide population‐based study

Biom J

Global burden of disease 2017 cirrhosis collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990‐2017: a systematic analysis for the global burden of disease study 2017

Lancet Gastroenterol Hepatol

Glucocorticoids induce bone and muscle atrophy by tissue‐specific mechanisms upstream of E3 ubiquitin ligases

Endocrinology

Connections between long-term use of topical corticosteroids (TCSs) of varying potency and osteoporosis and major osteoporotic fracture (MOF) are unclear. Susceptibility to adverse bone effects of TCSs in different sex, age and ethnic groups is unknown too.
To demonstrate the association between cumulative dose of TCSs of varying potency and osteoporosis and MOF in Taiwanese population, with stratified analysis of sex and age.
We conducted a nationwide case-control study and obtained data from Taiwan National Health Insurance Research Database. Cumulative TCS doses in different exposure periods were calculated, and the potency of TCSs was converted to prednisolone equivalent. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for osteoporosis and MOF associated with TCS use.
From 2017 to 2020, 129,682 osteoporosis cases and 34,999 MOF cases were selected and randomly matched with 518,728 and 139,996 controls by sex and age. We found clear dose-response relationships between long-term TCS exposure and osteoporosis and MOF. For example, compared to no TCS use, adjusted ORs of osteoporosis were 1.216 (95% CI 1.189-1.243), 1.260 (95% CI, 1.241-1.280) and 1.341 (95% CI, 1.314-1.369) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Adjusted ORs of MOF were 1.118 (95% CI 1.069-1.170), 1.191 (95% CI, 1.156-1.227) and 1.288 (95% CI, 1.238-1.340) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Stratified analysis showed women had higher ORs of osteoporosis and MOF compared to men. Younger people (<50 years) had highest OR of osteoporosis compared to other age groups.
Higher cumulative TCS dose was associated with increased risk of osteoporosis and MOF. Long-term use of TCSs should be cautious, especially in susceptible populations such as women and young people.

Higher cumulative dose of topical corticosteroids is associated with osteoporosis and major osteoporotic fracture: A nationwide case-control study.

Higher cumulative dose of topical corticosteroids is associated with osteoporosis and major osteoporotic fracture: A nationwide case–control study

Journal of the American Academy of Dermatology

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American Academy of Dermatology

Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies

J Am Acad Dermatol

GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations

J Clin Epidemiol

GRADE guidelines: 15. Going from evidence to recommendation-determinants of a recommendation's direction and strength

Guideline panels should seldom make good practice statements: guidance from the GRADE working group

A pragmatic approach to patch testing atopic dermatitis patients: clinical recommendations based on expert consensus opinion

Dermatitis

Patient-reported outcomes from a multicenter, randomized, vehicle-controlled clinical study of MAS063DP (Atopiclair) in the management of mild-to-moderate atopic dermatitis in adults

J Dermatolog Treat

Stand-alone emollient treatment reduces flares after discontinuation of topical steroid treatment in atopic dermatitis: a double-blind, randomized, vehicle-controlled, left-right comparison study

Acta Derm Venereol

A randomised, double-blind, vehicle-controlled study to evaluate the efficacy and safety of MAS063D (Atopiclair) in the treatment of mild to moderate atopic dermatitis

Eur J Dermatol

Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation

Skin Pharmacol Physiol

A double-blind study comparing the effect of glycerin and urea on dry, eczematous skin in atopic patients

Ectoine-containing cream in the treatment of mild to moderate atopic dermatitis: a randomised, comparator-controlled, intra-individual double-blind, multi-center trial

Efficacy of a moisturizer containing a pseudo-ceramide and a eucalyptus extract for Japanese patients with mild atopic dermatitis in the summer

J Cosmet Dermatol

The effect of lipopolysaccharide-containing moisturizing cream on skin care in patients with mild atopic dermatitis

In Vivo

Improvement of skin barrier function in atopic dermatitis patients with a new moisturizer containing a ceramide precursor

A randomized double-blind controlled trial to compare a triclosan-containing emollient with vehicle for the treatment of atopic dermatitis

Clin Exp Dermatol

Treatment with a barrier-strengthening moisturizing cream delays relapse of atopic dermatitis: a prospective and randomized controlled clinical trial

J Eur Acad Dermatol Venereol

Bathing in a magnesium-rich dead sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin

Int J Dermatol

Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis

Efficacy of sodium hypochlorite (bleach) baths to reduce staphylococcus aureus colonization in childhood onset moderate-to-severe eczema: a randomized, placebo-controlled cross-over trial

Bleach baths for eczema

Australas J Dermatol

Comparing the effect of bleach and water baths on skin barrier function in atopic dermatitis: a split-body randomized controlled trial

Br J Dermatol

Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia

J Dermatol

A pilot study on the use of wet wraps in infants with moderate atopic eczema

Efficacy of crisis intervention treatment with topical corticosteroid prednicarbat with and without partial wet-wrap dressing in atopic dermatitis

Dermatology

A randomised study of "wet wraps" versus conventional treatment for atopic eczema

Arch Dis Child

The proactive wet-wrap method with diluted corticosteroids versus emollients in children with atopic dermatitis: a prospective, randomized, double-blind, placebo-controlled trial

Topical steroids under wet-wrap dressings in atopic dermatitis--a vehicle-controlled trial

Intermittent therapy for flare prevention and long-term disease control in stabilized atopic dermatitis: a randomized comparison of 3-times-weekly applications of tacrolimus ointment versus vehicle

Tacrolimus ointment 0.03% shows efficacy and safety in pediatric and adult patients with mild to moderate atopic dermatitis

The impact of tacrolimus ointment on health-related quality of life of adult and pediatric patients with atopic dermatitis

Tacrolimus ointment for the treatment of atopic dermatitis is not associated with an increase in cutaneous infections

Tacrolimus ointment for the treatment of atopic dermatitis in adult patients: part I, efficacy

A short-term trial of tacrolimus ointment for atopic dermatitis. European Tacrolimus Multicenter Atopic Dermatitis Study Group

N Engl J Med

Tacrolimus ointment for the treatment of atopic dermatitis in adult patients: part II, safety

A randomized, open-label, multicenter trial of topical tacrolimus for the treatment of pruritis in patients with atopic dermatitis

Ann Dermatol

Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment

Allergy

Skin physiological parameters confirm the therapeutic efficacy of pimecrolimus cream 1% in patients with mild-to-moderate atopic dermatitis

Exp Dermatol

Pimecrolimus cream 1% in the long-term management of adult atopic dermatitis: prevention of flare progression. A randomized controlled trial

Molecular signatures order the potency of topically applied anti-inflammatory drugs in patients with atopic dermatitis

J Allergy Clin Immunol

Onset of pruritus relief with pimecrolimus cream 1% in adult patients with atopic dermatitis: a randomized trial

Sdz ASM 981: an emerging safe and effective treatment for atopic dermatitis

Pimecrolimus cream in the long-term management of atopic dermatitis in adults: a six-month study

A randomized controlled trial of pimecrolimus cream 1% in adolescents and adults with head and neck atopic dermatitis and intolerant of, or dependent on, topical corticosteroids

Effectiveness of the ascomycin macrolactam SDZ ASM 981 in the topical treatment of atopic dermatitis

Arch Dermatol

Clobetasol propionate 0.05% lotion in the treatment of moderate to severe atopic dermatitis: a randomized evaluation versus clobetasol propionate emollient cream

J Drugs Dermatol

Daily application of fluocinonide 0.1% cream for the treatment of atopic dermatitis

J Clin Aesthet Dermatol

A review of two controlled multicenter trials comparing 0.05% halobetasol propionate ointment to its vehicle in the treatment of chronic eczematous dermatoses

Betamethasone dipropionate ointment in the treatment of psoriasis and atopic dermatitis: a double-blind study

South Med J

Evaluation of a new method of assessing pruritus and antipruritic drugs

Skin Pharmacol

Twice weekly fluticasone propionate added to emollient maintenance treatment to reduce risk of relapse in atopic dermatitis: randomised, double blind, parallel group study

Clinical efficacy and tolerability of a novel selective corticosteroid in atopic dermatitis--two randomised controlled trials

Two randomized, double-blind, placebo-controlled studies of fluticasone propionate lotion 0.05% for the treatment of atopic dermatitis in subjects from 3 months of age

Intermittent dosing of fluticasone propionate cream for reducing the risk of relapse in atopic dermatitis patients

The management of moderate to severe atopic dermatitis in adults with topical fluticasone propionate. The Netherlands Adult Atopic DermatitisStudy Group

Efficacy and safety of hydrocortisone buteprate 0.1% cream in patients with atopic dermatitis

Clin Ther

Endolysin treatment against Staphylococcus aureus in adults with atopic dermatitis: a randomized controlled trial

Treatment of head and neck dermatitis with ciclopiroxolamine cream--results of a double-blind, placebo-controlled study

Topical treatment of atopic dermatitis with St. John's wort cream--a randomized, placebo controlled, double blind half-side comparison

Phytomedicine

Anti-pruritic effect of sertaconazole 2% cream in atopic dermatitis subjects: a prospective, randomized, double-blind, vehicle-controlled, multi-centre clinical trial of efficacy, safety and local tolerability

The effect of antibacterial soap with 1.5% triclocarban on Staphylococcus aureus in patients with atopic dermatitis

Cutis

Comparative effects of two topical antiseptics (chlorhexidine vs KMn04) on bacterial skin flora in atopic dermatitis

Acta Derm Venereol Suppl (Stockh)

Crisaborole and atopic dermatitis skin biomarkers: an intrapatient randomized trial

Long-term safety of crisaborole ointment 2% in children and adults with mild to moderate atopic dermatitis

A phase 2b, randomized, double-blind, multicenter, vehicle-controlled study to assess the efficacy and safety of two crisaborole regimens in Japanese patients aged 2 years and older with mild-to-moderate atopic dermatitis

Crisaborole topical ointment, 2% in adults with atopic dermatitis: a phase 2a, vehicle-controlled, proof-of-concept study

Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults

Treatment of atopic dermatitis with ruxolitinib cream (JAK1/JAK2 inhibitor) or triamcinolone cream

Effects of ruxolitinib cream on pruritus and quality of life in atopic dermatitis: results from a phase 2, randomized, dose-ranging, vehicle- and active-controlled study

Efficacy and safety of ruxolitinib cream for the treatment of atopic dermatitis: results from 2 phase 3, randomized, double-blind studies

Adult patients with moderate atopic dermatitis: tacrolimus ointment versus pimecrolimus cream

Chapter 2 - the t test for means

EASI, (objective) SCORAD and POEM for atopic eczema: responsiveness and minimal clinically important difference

Pharmacokinetics of topical calcineurin inhibitors in adult atopic dermatitis: a randomized, investigator-blind comparison

Tacrolimus ointment is more effective than pimecrolimus cream in adult patients with moderate to very severe atopic dermatitis

Tacrolimus ointment is more effective than pimecrolimus cream with a similar safety profile in the treatment of atopic dermatitis: results from 3 randomized, comparative studies

Association between topical calcineurin inhibitor use and risk of cancer, including lymphoma, keratinocyte carcinoma, and Melanoma: a systematic review and meta-analysis

JAMA Dermatol

Safety and efficacy of pimecrolimus in atopic dermatitis: a 5-year randomized trial

Pediatrics

A cohort study on the risk of lymphoma and skin cancer in users of topical tacrolimus, pimecrolimus, and corticosteroids (Joint European Longitudinal Lymphoma and Skin Cancer Evaluation - JOELLE study)

Clin Epidemiol

No evidence of increased cancer incidence in children using topical tacrolimus for atopic dermatitis

Association between topical calcineurin inhibitor use and keratinocyte carcinoma risk among adults with atopic dermatitis

Chapter 3: eczematous eruptions in childhood

Systematic review of treatments for atopic eczema

Health Technol Assess

Clinical comparison of alclometasone dipropionate cream 0.05% with hydrocortisone butyrate cream 0.1% in the treatment of atopic dermatitis in children

J Int Med Res

Double-blind, comparative clinical trials with halobetasol propionate cream in patients with atopic dermatitis

Effect of desonide hydrogel 0.05% on the hypothalamic-pituitary-adrenal axis in pediatric subjects with moderate to severe atopic dermatitis

Pediatr Dermatol

Improvement in treatment adherence with a 3-day course of fluocinonide cream 0.1% for atopic dermatitis

Established corticosteroid creams should be applied only once daily in patients with atopic eczema

Effects of a novel formulation of fluocinonide 0.1% cream on skin barrier function in atopic dermatitis

Efficacy and safety of methylprednisolone aceponate ointment 0.1% compared to tacrolimus 0.03% in children and adolescents with an acute flare of severe atopic dermatitis

Strategies for using topical corticosteroids in children and adults with eczema

Cochrane Database Syst Rev

Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: systematic review and meta-analysis of randomized controlled trials

Efficacy and safety of fluticasone propionate 0.005% ointment in the long-term maintenance treatment of children with atopic dermatitis: differences between boys and girls?

Pediatr Allergy Immunol

Skin colonization by staphylococcus aureus in patients with eczema and atopic dermatitis and relevant combined topical therapy: a double-blind multicentre randomized controlled trial

Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy

Co-operative double-blind trial of an antibiotic/corticoid combination in impetiginized atopic dermatitis

Clocortolone pivalate cream 0.1% used concomitantly with tacrolimus ointment 0.1% in atopic dermatitis

Long-term safety and tolerability of pimecrolimus cream 1% and topical corticosteroids in adults with moderate to severe atopic dermatitis

Different effects of pimecrolimus and betamethasone on the skin barrier in patients with atopic dermatitis

Effects of pimecrolimus compared with triamcinolone acetonide cream on skin barrier structure in atopic dermatitis: a randomized, double-blind, right-left arm trial

Superiority of tacrolimus 0.1% ointment compared with fluticasone 0.005% in adults with moderate to severe atopic dermatitis of the face: results from a randomized, double-blind trial

New evidence has emerged since the 2014 guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These guidelines update the 2014 recommendations for management of AD with topical therapies.
To provide evidence-based recommendations related to management of AD in adults using topical treatments.
A multidisciplinary workgroup conducted a systematic review and applied the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach for assessing the certainty of evidence and formulating and grading recommendations.
The workgroup developed 12 recommendations on the management of AD in adults with topical therapies, including nonprescription agents and prescription topical corticosteroids (TCS), calcineurin inhibitors (TCIs), Janus kinase (JAK) inhibitors, phosphodiesterase-4 inhibitors (PDE-4), antimicrobials, and antihistamines.
The pragmatic decision to limit the literature review to English-language randomized trials may have excluded data published in other languages and relevant long-term follow-up data.
Strong recommendations are made for the use of moisturizers, TCIs, TCS, and topical PDE-4 and JAK inhibitors. Conditional recommendations are made for the use of bathing and wet wrap therapy and against the use of topical antimicrobials, antiseptics, and antihistamines.

Guidelines of care for the management of atopic dermatitis in adults with topical therapies.

Guidelines of care for the management of atopic dermatitis in adults with topical therapies

JAMA Dermatology

<jats:sec><jats:title>Importance</jats:title><jats:p>Lebrikizumab (LEB), a high-affinity monoclonal antibody targeting interleukin (IL)-13, demonstrated efficacy and safety in patients with moderate-to-severe atopic dermatitis (AD) during 16 weeks of monotherapy in a phase 2b trial, and two 52-week phase 3 trials.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate efficacy and safety of LEB combined with low- to mid-potency topical corticosteroids (TCS) in patients with moderate-to-severe AD.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>The ADhere trial was a 16-week randomized, double-blinded, placebo (PBO)-controlled, multicenter, phase 3 clinical trial conducted from February 3, 2020, to September 16, 2021. The study was conducted at 54 outpatient sites across Germany, Poland, Canada, and the US and included adolescent (aged ≥12 to &amp;amp;lt;18 years weighing ≥40 kg) and adult patients with moderate-to-severe AD. The treatment allocation ratio was 2:1 (LEB:PBO).</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Overall, 211 patients were randomized to subcutaneous LEB (loading dose of 500 mg at baseline and week 2, followed by 250 mg every 2 weeks [Q2W] thereafter) or PBO Q2W in combination with TCS for 16 weeks.</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>Efficacy analyses at week 16 included proportions of patients achieving Investigator’s Global Assessment score of 0 or 1 (IGA [0,1]) with 2 or more points improvement from baseline, and 75% improvement in the Eczema Area and Severity Index (EASI-75). Key secondary end points included evaluation of itch, itch interference on sleep, and quality of life. Safety assessments included monitoring adverse events (AEs).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The mean (SD) age of patients was 37.2 (19.3) years, 103 (48.8%) patients were women, 31 (14.7%) patients were Asian, and 28 (13.3%) patients were Black/African American. At week 16, IGA (0,1) was achieved by 145 (41.2%) patients in the LEB+TCS group vs 66 (22.1%) receiving PBO+TCS (<jats:italic>P</jats:italic> = .01); corresponding proportions of patients achieving EASI-75 were 69.5% vs 42.2% (<jats:italic>P</jats:italic> &amp;amp;lt; .001). The LEB+TCS group showed statistically significant improvements in all key secondary end points. Most treatment-emergent adverse events (TEAEs) were nonserious, mild or moderate in severity, and did not lead to study discontinuation. The TEAEs frequently reported in the LEB+TCS group included conjunctivitis (7 [4.8%]), headache (7 [4.8%]), hypertension (4 [2.8%]), injection site reactions (4 [2.8%]), and herpes infection (5 [3.4%]) vs 1.5% or less patient-reported frequencies in the PBO+TCS group. Similar frequencies of patient-reported serious AEs following LEB+TCS (n = 2, 1.4%) and PBO+TCS (n = 1, 1.5%).</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>In this randomized phase 3 clinical trial, LEB+TCS was associated with  improved outcomes in adolescents and adults with moderate-to-severe AD compared with TCS alone, and safety was consistent with previously reported AD trials.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT04250337">NCT04250337</jats:ext-link></jats:p></jats:sec>

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Lancet

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Clin Exp Allergy

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Higher cumulative dose of topical corticosteroids is associated with osteoporosis and major osteoporotic fracture: A nationwide case–control study

Guidelines of care for the management of atopic dermatitis in adults with topical therapies

Efficacy and Safety of Lebrikizumab in Combination With Topical Corticosteroids in Adolescents and Adults With Moderate-to-Severe Atopic Dermatitis

Executive summary: American Academy of Dermatology guidelines of care for the management of atopic dermatitis in adults with topical therapies

Papers