The 15-year itch: A case of chronic atopic dermatitis unresponsive to topical corticosteroids

A man aged 29 years presented with a 15-year history of atopic dermatitis, which started on his feet and spread to his thighs, lower abdomen, back and buttocks (Figure 1). He reported severe and distressing pruritus that had a significant impact on his ability to work and sleep. He reported frustration as he had used multiple topical corticosteroid preparations, which would provide some initial relief then rapidly lose efficacy. He worked as a chef and described himself as otherwise well. His only regular medications were perindopril and agomelatine, both of which were initiated after the pruritus had commenced. He took no herbal or over-the-counter remedies. With the exception of childhood asthma that had resolved, he had no other features of atopy and did not have any family history of this or any other relevant medical concern. No other members of his household were affected, and he had no pets.