Peter Lio, MD 

2025 Revolutionizing Atopic Dermatitis (RAD) Conference

, Peter Lio, MD, spoke about topical steroid withdrawal at the atopic dermatitis-focused meeting.

Lio, who works at Northwestern University's Feinberg School of Medicine as a clinical assistant professor of dermatology and pediatrics, touched on the topic following his shared session about topical steroid withdrawal and its relationship to atopic dermatitis. He was asked about some of the most notable takeaways.

Addressing Doubts About Topical Steroid Withdrawal (TSW), with Peter Lio, MD

“There were 3 of us presenting on stage, and we got to go through different aspects of it,” Lio explained. “First, my piece was all about how we identify it? What is it? Is it a real thing? I think in this particular setting, most people, at least as far as I could tell, seem to acknowledge it as a real entity and want to understand it better. But I know that that's not true. I meet clinicians who say, ‘I don't think it's a real entity’ or ‘I think it's not different than atopic dermatitis,’ but I tried to convey some of the symptoms that are different. Some of the signs that are different and, most importantly, even if you don't acknowledge it or accept it, I think we should still hear our patient out.”

Lio added that one should still adapt to the patient and their needs related to corticosteroids.

“I wrote because I was so frustrated a couple of years ago by someone who said there's nothing else besides steroids,” Lio explained. “I wrote an entire paper about the therapeutic ladder of how we can treat atopic dermatitis without steroids at all, and I think it's pretty compelling. So when anyone says there's nothing outside of this, I'm like, ‘Here's an entire paper about the whole thing.’ We talked about that, and then the other sessions were really interesting too, about how we counsel the patients, and what we specifically do to treat it. Then finally, how do we bring all of this together?”

Lio was then asked about the doubts some physicians have related to topical steroid withdrawal.

“I hope some people who are doubtful watch it, and I hope it changes their minds,” Lio explained. “It's a powerful thing to be able to change somebody's mind. I love those moments in life when my mind gets changed, it's very exciting…I think that people feel that way for a couple of reasons. Number 1, it is relatively new. This is a bit of a controversial statement, because you can find threads in the literature for at least 20 years, and even beyond that. So it's not that new, but it's not something in the conventional canon.”

Lio noted that mainstream dermatology textbooks largely do not discuss topical steroid withdrawal.

“Part 2 is that patients often come in telling us that they have this, and that is a big reversal for dermatology,” Lio said. “We are quite used to, and I would say it's almost universal. Patients come in, or even other clinicians, even really good clinicians, come in telling us, ‘I don't know what this is, whether it's a rash, a spot, or some bumps, I don't know.’ We tell them what it is…This is backwards. The patient comes and says, ‘I think I have TSW,’ and we're not built for that. We know a lot more than the patients do, so I feel like it's a weird reaction to be threatened, but I get it. It feels threatening, like they're kind of trying to usurp you.”

Despite this initial feeling, Lio expressed that essentially all of the patients who have told him in his practice that they have TSW, he has agreed with them.

“I can reassure them ‘I see you know, you may not know this, but I'm a TSW person and I've written about it,’” Lio explained. “I say ‘I see a lot of patients with it, so I'm going to tell you very honestly, at this point, I do not think you or your child has this. We're going to treat you. We can even treat you like you have it, if you like’...Usually when I say that, their shoulders drop, they relax, and they smile."

For more from Lio and other session presenter, view our 

The quotes used in this summary were edited for clarity.

Videos

This interview with Peter Lio, MD, at RAD 2025 provides several insights into the topic of topical steroid withdrawal versus atopic dermatitis and what the distinction may be.

Peter Lio, MD, provided an on-site interview with the 

 in Nashville, and in this segment he spoke about the prospect of personalized medicine as well as other takeaways from one of his sessions on pediatric 

Lio serves as a clinical assistant professor of dermatology and pediatrics at Northwestern University's Feinberg School of Medicine. In this segment of his interview with 

, Lio was asked about his own focus on personalizing plans for caregivers of patients with atopic dermatitis as well as the potential for precision medicine practices in the near future.

Precision Medicine in Today’s Atopic Dermatitis Landscape, with Peter Lio, MD

“It's so important, this personalized or precision medicine we're heading towards,” Lio expressed. “I think that we're not there yet, and some of the things have been a little disappointing. We were thinking that when the first biologics came out back in 2017 that maybe they would help us subtype. The fancy term for this is a ‘diagnosis ex juvantibus’, where you can make a diagnosis or understand what's happening by what helps.”

Lio commented that some dermatologists had believed that if, for example, blockage of IL-4 and IL-13 took place, this might only treat a certain type of the disease and thus help to separate patients based on who the responders were.

“But it didn't work that way,” Lio said. “So we hadn't had a lot of insight into either the phenotype differences, what they look like, or the endotypes, like biomarkers or molecular markers, yet. But I think we're getting close, because it's starting to converge. There are definitely threads, but we we’re waiting for someone to pull them together into a cohesive story that is clinically actionable…For example, like if a treatment has the potential to cause conjunctivitis or has a chance to cause an allergic reaction or arthritis, maybe I'll be able to say, ‘You shouldn't get this one because you have this particular subtype, you're more likely to develop this problem.’ So that holistic picture of meeting the patient's needs with exactly the right therapy, that's the promise of precision medicine.”

Lio was later asked about some of the other points highlighted in his presentation at RAD regarding the treatment of pediatric atopic dermatitis.
“We talked a little bit about how we can keep the safety aspects of medicines in perspective,” Lio explained. “The analogy I sometimes use for patients who are worried about, let's say, a biologic, but they've been on multiple courses of prednisone or prednisolone. I'll say it's kind of like you've been riding around on a motorcycle without your helmet, and now you're worried about going in this commercial airline. [Of course] tere are risks to everything and I wish I could say there was no risk. But bad things can happen even if you're not on the medicine.”

Lio noted that while some medicines are known to be more risky than others, some of the newer drugs available for patients with atopic dermatitis have a lot more data behind them.

“We know that because a lot of the older medicines never had the kind of studies we have now,” Lio said. “It's a very different standard [than before] because they were there in the 60s or 70s, so we don't know. But the newer drugs have a really rigorous set of data. So again, it’s about trying to compare it and keep it in perspective and trying to balance the corticosteroid phobia.”

For any additional information presented at the RAD Conference in Nashville, view the 

. To learn more about Lio’s talk, view the full interview segment above.

The quotes contained in this summary were edited for clarity.

In this interview at RAD 2025, Peter Lio, MD, highlighted whether precision medicine is a possibility in the near future in the atopic dermatitis management space.

 in Nashville, Peter Lio, MD, spoke about some of the most notable takeaways from his talk titled ‘Pediatric AD: Patient, Provider, Caregiver Connection.’

Lio—known for his role as a clinical assistant professor of dermatology and pediatrics at Northwestern University's Feinberg School of Medicine—focused on the complex dynamics of care in pediatric dermatology, emphasizing the role of caregivers in addition to the pediatric patient. He highlighted key points of communication with caregivers in his interview with 

, including highlighting potential causes of skin flares.

Tips for Communicating with Caregivers for Pediatric Atopic Dermatitis, with Peter Lio, MD

“We talked about, first of all, the desire for patients to want to get to the root cause of the disease,” Lio explained. “I think that's been an incredibly exciting area in the science of atopic dermatitis, that we can talk about environmental triggers, that there are things out there. For example, one of the things we brought up was diisocyanate, a chemical that is produced by wildfire smoke, but also by exhaust from vehicles. It's even part of some volatile organic compounds that are produced from stuff that we bring into our houses and environments.”

This is something, Lio expressed, that seems to be able to damage the skin barrier, poison the microbiome, and potentially lead to atopic dermatitis. Later, Lio was asked about recent treatment options and ways to frame them to parents and caregivers.

“We have four biologics approved down to age 12 years, which is amazing,” Lio said. “So lots of kids can have access to 1 of those 4. We have 2 oral JAK inhibitors, and then we have a whole host of new topicals, a topical JAK inhibitor, a topical PDE4 inhibitor, and a topical aryl-hydrocarbon receptor modulator. Not to mention the hundreds and hundreds of pre-existing types of topical steroids and over-the-counter products. And there are just so many things that come into a visit. Which cleanser should I use? Do I have to use a special shampoo? What laundry detergent should I use? Can I use a fabric softener? What clothing should I wear?”

Lio noted that writing caregivers a written action plan for their children can be highly effective for communication, with the summary providing guidance.

“In the morning, I'd like you to do 123, in the evening, I'd like you to do 123, and then I'll often put a whole section of all the products with a link,” Lio explained. “By putting a link, they know specifically their product or a photograph of the product, that this is the one I want them to get, especially if you think about a larger line. [The company] might have a product that's designed for sensitive skin, but then they might have one that's for rough and bumpy skin, designed for your feet, or just not meant for a baby's face.”

To learn more about pediatric atopic dermatitis and related topics, view Lio’s full interview video posted above. For more on topics like this, view our 

This interview features a discussion with Lio regarding pediatric atopic dermatitis and the connection between caregivers, patients, and providers.

HCPLive Peter Lio, MD: RAD Preview

 continues to evolve at a rapid pace, the 

Revolutionizing Atopic Dermatitis (RAD) Annual Meeting

 remains a cornerstone for education, collaboration, and progress in patient care.

 has seen an explosion in interest and therapeutic advancement in recent years. There are more options than ever but figuring out how to use them in real life with real patients has made clinician education on the topic more important than ever.

“When you focus on a disease state, not only do you get reinforcement, you get a number of experts really taking you from the very beginning all the way up to the highest level discussions. You're going to get privy to some of the most interesting questions that everybody's wrestling with who's actually doing the research at the moment,” explained Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of Chicago Integrative Eczema Center, in an interview. “And for me, this is where I learned the most.”

At the RAD 2024 meeting, the community welcomed the presentation of LEVEL UP data, the Measure Up program, and the DELTA studies. Beyond updates in clinical trials and guideline adoption, the RAD annual meeting also shines a spotlight on other clinically relevant aspects of care, such as management of skin of color, comorbidity management, and more.

In this interview, Lio, who will be leading a session at the meeting, which takes place June 06-07, 2025 in Nashville, TN, talks about why RAD has become one of the most valuable meetings for anyone treating atopic dermatitis. He shares why the sessions, the speakers, and the conversations happening are different from other meetings through a specific focus on real-world challenges, patients, and optimizing care.

Relevant disclosures for Lio include AbbVie, Almirall, Arbonne, ASLAN Pharmaceuticals, Dermavant, Eli Lilly and Company, Galderma, Johnson & Johnson, L’Oreal, LEO Pharma, Pfizer, Regeneron/Sanofi Genzyme and others.

Campbell P. MJH Life Sciences Celebrates Acquisition of Revolutionizing Atopic Dermatitis (RAD) Annual Meeting. HCP Live. Published November 11, 2024. Accessed April 9, 2025. 

https://www.hcplive.com/view/mjh-life-sciences-celebrates-acquisition-of-revolutionizing-atopic-dermatitis-rad-annual-meeting

Peter Lio, MD, discusses the value of hyperfocused meetings such as RAD and what sessions he is most looking forward to at RAD 2025.

Peter Lio, MD

Articles