Risks of topical corticosteroid therapy and role for advanced targeted topical treatments for inflammatory skin diseases: an expert consensus panel.

Topical corticosteroids are a first-line therapy for inflammatory skin diseases and are commonly used for chronic management. Topical corticosteroids can lead to cutaneous and systemic adverse events. The purpose of this expert consensus panel was to review published literature on the safety and efficacy of topical corticosteroids and role for advanced targeted topical therapies for inflammatory skin diseases. A comprehensive literature search was completed using a combination of keywords: "topical," "corticosteroid," "non-steroid," "efficacy," "adverse effects," "malpractice," and "inflammatory skin diseases." Articles were screened for relevance to topic of safety and efficacy of topical corticosteroids and noncorticosteroid therapies for inflammatory skin diseases. A panel of four dermatologists with expertise treating inflammatory skin diseases reviewed the articles and created consensus statements. A modified Delphi process was used to approve each statement and a strength of recommendation was assigned. The literature search produced 350 articles. A screening of the studies resulted in 24 articles that met criteria. The panel unanimously voted to adopt 10 consensus statements and recommendations. Topical corticosteroids and systemic corticosteroids are associated with numerous adverse effects, and medical-legal risks for clinicians prescribing these medications exist. Advanced targeted topical therapies have demonstrated safety and effectiveness as an alternative to corticosteroids.