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–)
Q&A
Once-daily topical steroid dosing effective for atopic eczema
- 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.