Trends in Atopic Dermatitis Management: A NAMCS Retrospective Analysis (2013-2019)

The management of atopic dermatitis (AD) has significantly evolved over the past decade, guided by the 2014 American Academy of Dermatology (AAD) guidelines, which advocate for a stepwise approach emphasizing reduced reliance on topical corticosteroids (TCS) and increased use of steroid-sparing agents like calcineurin inhibitors (TCIs) and phosphodiesterase-4 (PDE4) inhibitors. This small study analyzed prescribing patterns for AD from 2013 to 2019 using data from the National Ambulatory Medical Care Survey (NAMCS). A total of 162 AD patients were categorized into four treatment groups: topical therapy only, immunosuppressant therapy only, adjunctive therapy, and other treatments. Chi-square analysis revealed a significant association between prescribing trends and year (χ² (15) = 38.85, p = 0.001), with a marked reduction in TCS use and increased prescriptions of TCIs and PDE4 inhibitors after 2016. These findings demonstrate a shift in clinical practice towards guideline-based care, reducing long-term reliance on TCS and favoring safer, steroid-sparing therapies to optimize patient outcomes.