I received a copy of an article titled, “Topical corticosteroids for treatment-resistant atopic dermatitis” by a fellow dermatologist. I assumed it would be a fun vintage historical insight into what we were taught in the 1960s. I should know better than to jump to conclusions. The article appeared in the September, 2018 edition of a widely distributed dermatology periodical loaded with drug company advertisements. This particular infomercial was written by six authors from Wake Forest School of Medicine Dermatology Department and sponsored by Taro Pharmaceuticals, a company that sells a variety of topical steroid creams in all strengths.
The practice points cited were:
- mid-potency corticosteroids are the first line treatment of atopic dermatitis.
- atopic dermatitis may fail to respond to topical corticosteroids initially or lose response over time, a phenomenon known as tachyphylaxis.
- non-adherence to medication is the most likely cause of treatment resistance in patients with AD.
My criticisms of this infomercial run the gamut of:
- being a drug company marketing ploy
- a dermatology department being “bought”
- being a laughable article boasting of “research” with material that was covered 60 years ago and shown to be false
- blaming patients for failure of medical acumen and judgement
- physicians insistence upon prescribing topical steroids that frequently cause Red Skin Syndrome (RSS) and the needless suffering that accompanies the condition
- physicians refusal to recognize the existence of RSS and that the condition is completely curable by total withdrawal from steroids
These medical “researchers” need to be reminded that their responsibility is to serve the patients not the drug companies. Dermatologists who receive money to write misleading infomercials recommending the chronic usage of topical steroids are ignoring their oath to “First, do no harm.”