Lewis Daniel J, Feldman Steven R
Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
School of Medicine, Baylor College of Medicine, Houston, TX, USA.
Pediatr Dermatol. 2018 Mar;35(2):278-279. doi: 10.1111/pde.13376. Epub 2018 Jan 4.
Atopic dermatitis is responsive to midpotency topical corticosteroids, which are the mainstay of treatment, yet many patients have disease that is "resistant" to triamcinolone prescribed for outpatient use. Such resistance is often due to poor adherence, but patients and caregivers may remain adamant that the steroid was ineffective and assure the physician that it was applied as recommended. We describe the case of a young girl with a 2-year history of atopic dermatitis resistant to triamcinolone whose condition rapidly improved with continued use of triamcinolone. Our case raises the ethical dilemma of whether physicians should base treatment plans on what patients report or what evidence on adherence suggests.
