Drug Company Still Marketing Steroids

I received a copy of an article titled, “Topical corticosteroids for treatment-resistant atopic dermatitis” by a fellow dermatologist. I assumed it would be a fun vintage historical insight into what we were taught in the 1960s. I should know better than to jump to conclusions. The article appeared in the September, 2018 edition of a widely distributed dermatology periodical loaded with drug company advertisements. This particular infomercial was written by six authors from Wake Forest School of Medicine Dermatology Department and sponsored by Taro Pharmaceuticals, a company that sells a variety of topical steroid creams in all strengths.

The practice points cited were:

mid-potency corticosteroids are the first line treatment of atopic dermatitis.
atopic dermatitis may fail to respond to topical corticosteroids initially or lose response over time, a phenomenon known as tachyphylaxis.
non-adherence to medication is the most likely cause of treatment resistance in patients with AD.

My criticisms of this infomercial run the gamut of:

being a drug company marketing ploy
a dermatology department being “bought”
being a laughable article boasting of “research” with material that was covered 60 years ago and shown to be false
blaming patients for failure of medical acumen and judgement
physicians insistence upon prescribing topical steroids that frequently cause Red Skin Syndrome (RSS) and the needless suffering that accompanies the condition
physicians refusal to recognize the existence of RSS and that the condition is completely curable by total withdrawal from steroids

These medical “researchers” need to be reminded that their responsibility is to serve the patients not the drug companies. Dermatologists who receive money to write misleading infomercials recommending the chronic usage of topical steroids are ignoring their oath to “First, do no harm.”

By Dr Marvin Rapaport, MD|2021-10-19T03:16:45-07:00November 2nd, 2018|False Treatments, Red Skin Syndrome|Comments Off

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.