Once-daily topical steroid dosing effective for atopic eczema

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  • Clinical Question: Is dosing topical corticosteroids more than once a day better than once-daily dosing for atopic eczema?
  • Study Design: Meta-analysis (randomized controlled trials)
  • Setting: Outpatient (any)
  • Synopsis: The authors searched the literature for randomized controlled trials (RCTs) comparing once-daily with more frequent dosing of topical corticosteroids for atopic eczema. They excluded studies of seborrheic eczema, varicose eczema, discoid eczema, and contact dermatitis. The 2 primary outcomes consistent between most studies was “at least a good response or 50% improvement” and “eczema rated as cleared or controlled.” The meta-analysis was well executed with a comprehensive search, a good description of inclusion criteria, careful abstracting of data, and an appropriate analysis.


Bottom Line

Patients should begin with once-daily dosing of topical corticosteroids for atopic eczema, increasing to twice or 3 times per day only if symptoms are not well controlled. (LOE=1a–)

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