to the editor: I was surprised that the authors1 of the article on atopic dermatitis recommended consideration of treatment using an oral leukotriene inhibitor (speculative at best!) but failed to include tar compounds (tried-and-true).
I believe the latter compounds are widely underused. This is unfortunate because they are safe and effective, and they also potentiate topical steroids when used in combination therapy, thus allowing a reduction in potent steroid use. Tar compounds are photosensitizing and may stain, but these problems can be minimized when they are applied only at night. These preparations are usually very well tolerated, and some can be added to bath water.
in reply: I agree with Mr. Zimmerman that tar compounds are appropriate intervention for patients with atopic dermatitis. Regrettably, they are very inconvenient to use so I try to avoid them in my practice; nonetheless, they are time tested and proven to be effective. Also, I agree with Mr. Zimmerman that leukotriene inhibitors are speculative at best, and a study needs to be conducted in the double-blind fashion to confirm our suspicions that leukotriene receptor antagonists are beneficial for persons with atopic dermatitis.