I take a detour today from many more Dupilumab stories by concentrating on a new ITSAN appeal for donations over the heading “I wish I would have known (about steroids).” The implications of this new campaign are that it is an evil drug. Steroid creams used properly in the proper strength for the correct amount of time are a wonder drug and solve thousands of medical problems every day. They can easily and fruitfully be used in eczema patients under proper medical management for very short periods of time. The ITSAN comment above is comparable to saying that opioids for a short period of time are evil when in fact they are magical in relieving severe pain when used properly. It is totally inappropriate for ITSAN to be giving this type of uninformed and unscientific medical advice.
About the Author: Dr Marvin Rapaport, MD
In 1978 I initiated and set up the contact and photo dermatitis clinic at UCLA. There was a need to evaluate a large group of patients who exhibited severe eczematoid rashes, especially on the face. Patients were referred from all over Southern California. All patients underwent a lengthy history and examination. Further evaluations included blood studies, allergy patch testing, special sunlight (photo) testing and skin biopsies. From the start it was apparent that most patients experienced a mild dermatitis on various parts of the body that progressively worsened. Their histories always included numerous doctor visits, multiple physicians, and therapy consisting of an increasing amount of corticosteroids. My testing failed to reveal any specific culprit chemicals, cosmetics, perfumes, workplace or recreational exposures. It became increasingly clear that the physician’s therapy, the corticosteroids, was invariably causing the problem. I wrote 7 scientific articles that were published in the most august peer-reviewed dermatologic journals and I gave many lectures at various dermatology meetings. To this day an unfortunate reluctance exists on the part of most physicians to accept this simple concept.