Recurrence Rates in Paediatric Patients With Atopic Dermatitis: A Comparison Between Topical and Systemic Treatments

ABSTRACT Background Atopic dermatitis (AD) is a chronic, relapsing skin condition that significantly affects children and their families. Treatment ranges from topical to systemic therapies, but evidence on long‐term recurrence following different treatment strategies in paediatric AD remains limited. Objectives To explore recurrence rates in paediatric patients with AD after topical versus systemic treatment in a specialised AD clinic. Methods This retrospective observational study included children (0–12 years) diagnosed with AD and treated at a tertiary university hospital in Denmark between 2019 and 2023. Patients were grouped based on treatment: systemic (with topical) versus topical only. Re‐referral to the department served as a proxy for recurrence. Kaplan–Meier curves were used to estimate time to re‐referral. Cox proportional hazards regression adjusted for baseline disease severity (mild, moderate and severe). Results A total of 166 patients were included. Around 50% of discharged patients were re‐referred within 30 months. Kaplan–Meier analysis suggested a trend towards longer remission in those treated with systemic therapy compared to topical treatment alone. In Cox regression, receiving only topical treatment showed a non‐significant trend towards higher risk of re‐referral (HR = 5.5, 95% CI: 0.73–41.8), while higher baseline disease severity was significantly associated with increased risk of re‐referral (HR = 2.3, 95% CI: 1.2–4.5). Conclusions Systemic therapy may be associated with longer remission periods in paediatric AD, particularly in patients with more severe disease. While some findings were not statistically conclusive, the results indicate a trend that underlines the importance of individualised treatment strategies balancing efficacy and long‐term disease control.