Peer-Reviewed Publication
World Allergy Organ J2026;19(5):101380.May 1, 2026Journal Article
The definition of response and inadequate response to topical corticosteroid treatment in atopic dermatitis and related skin inflammatory diseases: A GA2LEN ADCARE statement paper.
Torsten Zuberbier1,2, Mohamed Abuzakouk3, Irena Angelova Fischer4, Luisa Karla Arruda5, Matthias Augustin6, Lisa Beck7, Jonathan Bernstein8, Carsten Bindslev-Jensen9,10, Marta Bertolín-Colilla11, Christine Bangert12, Oscar Calderón-Llosa13, Giorgio Walter Canonica14,15, Mary Anne Roldan-Castor16, Roxanne J Casis-Hao17, Ivan Cherrez-Ojeda1,18,19, Karen Jui Lin Choo20, Leena Chularojanamontri21, Michael J Cork22,23, Timothy J Craig24, Paulo Ricardo Criado25,26, Adnan Custovic27, Tubanur Çetinarslan28, Furkan Çalıcıoğlu29, Marjolein de Bruin-Weller30, Nikolaos Douladiris31, Luis Felipe Ensina32, Yasemin Erdem Öztürk33, Ragip Ertaş20, Silvia Mariel Ferrucci34, Nelson Rosário Filho35, Carsten Flohr36, Joachim Fluhr1,2, Daria Fomina37,38,39, Stamatios Gregoriou40, Maia Gotua41,42, Ana Maria Giménez-Arnau43, Wolfram Hoetzenecker44, Carolyn Jack45, Roberta Fachini Jardin Criado18,19, Norito Katoh46, Alexandros Katoulis47, Şefika İlknur Kökçü Karadağ48, Desiree Larenas-Linnemann49, Haur Yueh Lee50,51,52, Herminio Lima53, Eli Mansour54, Charlotte G Mortz55, Mara Morelo Rocha Felix56, Victor Morris57, Ana Moschione Castro58,59, Dayanne Mota Veloso Bruscky60, Olga Mukhina61, Dinh Van Nguyen62,63, Audrey Nosbaum64,65,66, Deniz Ozceker32, Esen Özkaya24, Rabia Oztas Kara67, Claudio A S Parisi68, Jonny Peter69,70, Luis Puig71,72,73, German Dario Ramon74,75, Catalina Rincón-Pérez76, Umit Murat Sahiner77, Peter Schmid-Grendelmeier78,79,80, Esther Serra-Baldrich58,59,60, Bahar Sevimli Dikicier81, Catherine H Smith36, Petra Staubach82, Katarina Stevanovic1,2, Ozlem Su Kucuk83, Natasa Teovska Mitrevska84,85, Diamant Thaci86, Maria Jose Torres87, Tiago Torres88, Maria Eduarda Trócoli Zanetti5, Papapit Tuchinda14, Zahava Vadasz89, Efstratios Vakirlis90, Gleison Vieira Duarte91, Hannele Virtanen92, Thomas Werfel93, Andreas Wollenberg94,95,96, Margitta Worm97, Yik Weng Yew98, Manuel P Pereira1,2
1Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
2Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
3Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
4Department of Dermatology, Kepler University Hospital, Linz, Austria.
5Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
6University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
7Department of Dermatology, University of Rochester, Rochester, USA.
8University of Cincinnati, Dept of Medicine, Division of Allergy and Immunology, Cincinnati, OH, USA.
9Odense Research Center for Anaphylaxis, Odense University Hospital, Odense, Denmark.
10Department of Dermatology and Allergy Center, Odense University Hospital, Odense, Denmark.
11Dermatology Department, Hospital del Mar. Hospital del Mar Research Institute, Universitat Autònoma, Universitat Pompeu Fabra, Barcelona, Spain.
12Department of Dermatology, Medical University of Vienna, Vienna, Austria.
13SANNA Clínica el Golf, San Isidro, Lima, Peru.
14Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milano, Italy.
15Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Italy.
16Division of Allergy and Immunology Department of Pediatrics College of Medicine - Philippine General Hospital c Manila, Philippines.
17University of the Philippines Manila-Philippine General Hospital Division of Allergy & Immunology, Manila, Philippines.
18Espiritu Santo University, Samborondon, Ecuador.
19Respiralab Research Group, Guayaquil, Ecuador.
20Department of Dermatology, Singapore General Hospital, Singapore.
21Department of Dermatology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
22Sheffield Children's NIHR Commercial Research Delivery Centre, Sheffield, United Kingdom.
23Sheffield Dermatology Research, Division of Clinical Medicine, University of Sheffield Medical School, United Kingdom.
24Penn State University, Hershey, Pa, Vinmec International Hospital, Times City, Hanoi, Vietnam.
25Centro Universitário Faculdade de Medicina do ABC, Santo André, Brazil.
26Alergoskin Alergia e Dermatologia SS Ltda, Santo André, Brazil.
27National Heart and Lung Institute, Imperial College London, United Kingdom.
28Manisa Celal Bayar University, Department of Dermatology and Venereology, Manisa, Turkey.
29Health Sciences University, Kayseri Faculty of Medicine, Kayseri City Hospital, Department of Dermatology, Urticaria & Angioedema & Atopic Dermatitis Center of Reference and Excellence Clinic, Turkey.
30University Medical Center Utrecht, the Netherlands.
31Clinical & Molecular Allergology Center, Chalkidiki, Greece.
32CPAlpha Clinical Research Center, Barueri, Brazil.
33İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, 34093 Çapa-İstanbul, Turkey.
34Dermatology Unit. IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation of Milan, Italy.
35Federal University of Parana, Brazil.
36Kings College London, United Kingdom.
37Global Allergy and Asthma European Network (GA2LEN) Urticaria and Angioedema Center of Reference and Excellence (UCARE/ACARE), Moscow City Research and Clinical Center of Allergy and Immunology, City Clinical Hospital 52, Moscow Healthcare Department, Moscow, Russia.
38Department of Clinical Immunology and Allergy, The First Sechenov State Medical University, Moscow, Russia.
39Department of Pulmonology, Astana Medical University, Astana, Kazakhstan.
40National and Kapodistrian University of Athens, 1st Department of Dermatology, Andreas Sygros Hospital, Athens, Greece.
41Center of Allergy and Immunology, UCARE, ADCARE, ACARE and ANACARE Centers, Tbilisi, Georgia.
42David Tvildiani Medical University, Tbilisi, Georgia.
43Dermatology Department, Hospital del Mar. Hospital del Mar Research Institute Universitat Autonoma, Universitat Pompeu Fabra, Barcelona, Spain.
44Affiliation: Department of Dermatology, Kepler University Hospital, Medical Faculty, Linz, Austria.
45Innovaderm Research, Montreal, Quebec, Canada.
46North Campus, Kyoto Prefectural University of Medicine, Japan.
472nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Attikon General University Hospital, Athens, Greece.
48Prof.Dr.Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.
49Center of Excellence in Asthma andnAllergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
50Senior Consultant, Department of Dermatology, Singapore General Hospital, Singapore.
51Allergy Centre, Singapore General Hospital, Singapore.
52DUKE-NUS Medical School, Singapore.
53McMaster University Division of Clinic Immunology and Allergy and Division of Dermatology, Hamilton, ON, Canada.
54Allergy and Immunology, Department of Internal Medicine, School of Medical Sciences, University of Campinas/UNICAMP, Campinas, Brazil.
55Department of Dermatology and Allergy Center, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
56Alergolife Center, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
57St Luke's General Hospital Carlow/Kilkenny, Kilkenny, Ireland.
58Clinica Croce, São Paulo, SP, Brazil.
59Unidade de Alergia e Imunologia Instituto da Criança HCFMUSP, São Paulo, SP, Brazil.
60Universidade Federal de Pernambuco, Recife, Brazil.
61Moscow Clinical Hospital 52 Research Center of Allergy and Immunology Moscow, Russia.
62Vinmec-VinUni Institute of Immunology, VinUniversity, Hanoi, Vietnam.
63Center of Allergy and Clinical Immunology, Vinmec Times City Hospital, Vinmec Healthcare System, Hanoi, Vietnam.
64Hospices Civils de Lyon, Service d'Allergologie et Immunologie Clinique, 69495 Pierre Benite cedex, France.
65Université Claude Bernard, Lyon, France.
66Epidermal Immunity and Allergy, Centre International de Recherche en Infectiologie (CIRI), Lyon France.
67Department of Dermatology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
68Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.
69Division of Allergy and Clinical Immunology, Groote Schuur Hospital, Department of Medicine, University of Cape Town, South Africa.
70Allergy and Immunology Unit, University of Cape Town Lung Institute, South Africa.
71Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
72Universitat Autònoma de Barcelona, Barcelona, Spain.
73Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain.
74Hospital Italiano Regional del Sur, Buenos Aires, Argentina.
75Instituto de Alergia e Inmunología del Sur, Buenos Aires, Argentina.
76Unidad de Especialidades Medicas, Universidad del Ejercito y Fuerza Aérea Mexicana, SEDENA, Mexico.
77Pediatric Allergy Department Hacettepe University Childrens Hospital, 06230, Ankara, Turkey.
78Allergiestation, Dermatologische Klinik, Universitätsspital, Zürich, Switzerland.
79Dermatologische Abteilung, Hochgebirgsklinik Davos Wolfgang, Medizincampus Davos, Switzerland.
80Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland.
81Sakarya University School of Medicine, Department of Dermatology, Sakarya Training and Research Hospital, Sakarya, Turkey.
82Department of Dermatology University Medical Center Mainz Germany, Germany.
83Bezmialem Vakif University School of Medicine Dermatology Department, Adnan Menderes Bulvarı Vatan Street PK 34093 Fatih, İstanbul, Turkey.
84Remedika General Hospital, dermatology department, Skopje, Macedonia.
85International Balkan University, Skopje, Macedonia.
86Institute and Comprehensive Center for Inflammation Medicine, University of Luebeck, Luebeck Germany.
87Allergy Unit, IBIMA-Hospital Regional Universitario de Málaga-ARADyAL, UMA, Málaga, Spain.
88Department of Dermatology, Centro Académico Clínico, ICBAS/Santo António, University of Porto, Portugal.
89BnaiZion Medical Center, Haifa, Israel.
90First Department of Dermatology-Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece.
91IBIS - Instituto Bahiano de Imunoterapia, Brazil.
92Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
93Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
94Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Germany.
95Comprehensive Center for Inflammation Medicine, University of Luebeck, Luebeck, Germany.
96Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany.
97Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Germany.
98National Skin Centre, Singapore.
Abstract
BACKGROUND: Topical corticosteroids (TCS) remain the first-line treatment for atopic dermatitis (AD) and related inflammatory skin diseases, yet no standardized definition of response exists. This gap contributes to heterogeneity in clinical practice and complicates trial design. We therefore aimed to develop consensus-based definitions of response and inadequate response to TCS therapy through a…
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