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Published on: September 26, 2019

Incidence of Skin Infections in Patients with Atopic Dermatitis Treated with Topical Medications: A Cohort Study

Akio Tanaka1, Rikiya Toda2, Takahiro Tsuchiya2

  • 1Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Dermatology and Therapy
|June 3, 2026
PubMed
Abstract

Insights

Difamilast shows a similar skin infection risk to topical corticosteroids (TCS) and other non-TCS treatments in atopic dermatitis (AD) patients. This study emphasizes monitoring infection risk with topical AD medications.

Area of Science:

  • Dermatology
  • Pharmacovigilance
  • Real-world evidence

Background:

  • Skin infections are a significant concern for atopic dermatitis (AD) patients using topical medications like topical corticosteroids (TCS), tacrolimus, delgocitinib, and difamilast.
  • Limited real-world data exists on the comparative incidence of skin infections across these topical treatments.

Purpose of the Study:

  • To evaluate patient characteristics and the incidence rates of skin infections associated with difamilast, TCS, and non-TCS (tacrolimus, delgocitinib) treatments in AD patients.
  • To compare the real-world safety profiles of these topical medications concerning skin infection risk.

Main Methods:

  • Retrospective cohort study utilizing Japanese health insurance claims data (June 2022-June 2023).
  • Patients with AD were categorized into difamilast, TCS, and non-TCS groups.
  • Incidence rates were calculated per 1000 person-years, with propensity score matching employed for group comparisons.

Main Results:

  • After propensity score matching, difamilast showed a comparable incidence rate of skin infections to TCS (Risk Ratio: 1.185) and a slightly higher rate compared to non-TCS (Risk Ratio: 1.302).
  • No significant differences in individual skin infection incidence were noted, except for acne.
  • The incidence of skin infections in difamilast monotherapy patients aligned with the overall difamilast group.

Conclusions:

  • Difamilast exhibits a comparable safety profile to other topical treatments concerning skin infections in AD patients.
  • Findings underscore the necessity of monitoring infection risk and implementing appropriate clinical management for topical AD therapies.
Keywords:
Atopic dermatitisSkin infectionsTopical medications

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