Back to decision-making tree Print last updated on 08/02/2026

Indications

Systemic treatment for AD is necessary when clinical signs are not sufficiently controlled by appropriate topical treatments and/or phototherapy. Systemic treatment may also be useful for reducing the total amount of TCS (topical corticosteroids) in patients who must use large quantities over an extensive body surface area for prolonged periods to control their AD.

We propose that systemic treatment be initiated if:

• The atopic dermatitis is poorly controlled (high severity score such as SCORAD > 50 and/or major impact on quality of life) despite appropriate and well-conducted local treatment,
• or
• The patient is unable to carry out appropriate local treatment,
• or
• The quantity of topical corticosteroids required to control the disease over the long term is greater than 4 tubes (30 grams each) of high-potency topical corticosteroids per month in adults.

NB.

See the Toolbox: clinical severity scores for AD.