Problems Associated with Inadequate Treatment for Atopic Dermatitis

W idespread confusion currently exits in Japan with regard to the treat- ment of atopic dermatitis, creating a difficult social problem. As a background to this confusion, the mass media have been highly critical of topical steroids and have given the general public the idea that steroid ointments are dangerous, although proper use of these ointments is essential for the treatment of atopic dermatitis, as is commonly recognized throughout the world. A so-called "atopy industry" has sprung up in which alternative remedies are used to treat atopic dermatitis, creating large numbers of patients with severe problems resulting from inadequate methods of treatment. In 1998, the Japanese Dermatological Associa- tion (JDA) organized a committee to survey the health damage caused by inad- equate treatment of atopic dermatitis, and the committee published its final results in 2000. Among 310 severe cases, a surprisingly high 140 cases (44%) were worsened by inadequate treatment, whereas only 3 patients suffered from side effects of steroid ointment treatment. The JDA organized a new committee in June 2000, to examine the problems of treatment in atopic dermatitis. One of the major activities of this committee is direct consultation with patients via e-mail and fac- simile. After the initiation of this system, the committee has received 1,504 requests for consultation within 9 months. Dermatologists need to exert much greater effort to solve this social problem.