I appreciate the observations and comments made by Rapaport1 in the February issue of the Archives and agree that a subset of patients with chronic eczema experience corticosteroid dependence and rebound flare. This is probably more common in adults, especially among those who have been treated with long-term topical corticosteroids on the face and groin. Another subset of patients with eczema have severe atopic dermatitis that does not reliably respond to any of the “panoply” of other described options.
Siegfried EC. Long-term Follow-up of a Child Treated With Efalizumab for Atopic Dermatitis. Arch Dermatol. 2007;143(8):1073-1087. doi:10.1001/archderm.143.8.1077