Ann Dermatol.  2015 Oct;27(5):499-506. 10.5021/ad.2015.27.5.499.

Topical Corticosteroid Phobia among Parents of Children with Atopic Eczema in Korea

Affiliations
  • 1Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 2Department of Dermatology, Kangwon National University School of Medicine, Chuncheon, Korea. young6078@hanmail.net

Abstract

BACKGROUND
Topical corticosteroids (TCS) are the first-line agents for the treatment of atopic dermatitis (AD). However, a vague phobia concerning the use of TCS exists among parents of children with AD because of misinformation, and studies on the subject are insufficient.
OBJECTIVE
To assess the current state of steroid phobia among parents of atopic children in Korea and to investigate the importance of education in its reduction.
METHODS
By using a structured questionnaire, 126 parents of children with AD (22.2% fathers, 77.8% mothers) were interviewed. After the questionnaire administration, all participants were educated about TCS use.
RESULTS
Overall, 67.5% of the parents showed steroid phobia. A statistical correlation was found between steroid phobia and knowledge of potential adverse events, experience of TCS use, and adherence to treatment (p<0.05). Adherence to treatment tended to be lower among parents with steroid phobia. The most recognized adverse effects of TCS were skin atrophy and thinning (71.9%). The most prevalent information source leading to steroid phobia was the Internet (49.2%). The risk factors for steroid phobia were AD severity (odds ratio [OR]=5.332 [moderate], 9.040 [severe] vs. mild; p=0.001) and the knowledge of potential adverse events (OR=2.658; p=0.021).
CONCLUSION
We found a high prevalence of steroid phobia among parents of patients with AD, and here show the impact of this phobia on treatment adherence. We emphasize the important role of dermatologists as providers of accurate information and appropriate education about the use of TCS.

Keyword

Atopic dermatitis; Steroid phobia; Topical corticosteroid

MeSH Terms

Adrenal Cortex Hormones
Atrophy
Child*
Dermatitis, Atopic*
Education
Fathers
Humans
Internet
Korea*
Parents*
Phobic Disorders*
Prevalence
Risk Factors
Skin
Adrenal Cortex Hormones

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Reference

1. Bieber T. Atopic dermatitis. Ann Dermatol. 2010; 22:125–137.
Article
2. Williams HC. Clinical practice. Atopic dermatitis. N Engl J Med. 2005; 352:2314–2324.
3. Chamlin SL. The psychosocial burden of childhood atopic dermatitis. Dermatol Ther. 2006; 19:104–107.
Article
4. Yang HJ, Jeon YH, Pyun BY. Evaluation of patients subjective severity using various scoring system in Korean children with atopic dermatitis. Asian Pac J Allergy Immunol. 2010; 28:130–135.
5. Zuberbier T, Orlow SJ, Paller AS, Taïeb A, Allen R, Hernanz-Hermosa JM, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol. 2006; 118:226–232.
Article
6. Kim SY, Lee SD, Kim HO, Park YM. A survey of the awareness, knowledge, and behavior of topical steroid use in dermatologic outpatients of the university hospital. Korean J Dermatol. 2008; 46:473–479.
7. Chin HW, Jang HS, Jang BS, Jo JH, Kim MB, Oh CK, et al. A study on utilization of alternative medicine for patients with atopic dermatitis. Korean J Dermatol. 2005; 43:903–911.
8. David TJ. Steroid scare. Arch Dis Child. 1987; 62:876–878.
Article
9. Charman CR, Morris AD, Williams HC. Topical corticosteroid phobia in patients with atopic eczema. Br J Dermatol. 2000; 142:931–936.
Article
10. Hon KL, Kam WY, Leung TF, Lam MC, Wong KY, Lee KC, et al. Steroid fears in children with eczema. Acta Paediatr. 2006; 95:1451–1455.
Article
11. Smith SD, Hong E, Fearns S, Blaszczynski A, Fischer G. Corticosteroid phobia and other confounders in the treatment of childhood atopic dermatitis explored using parent focus groups. Australas J Dermatol. 2010; 51:168–174.
Article
12. Aubert-Wastiaux H, Moret L, Le Rhun A, Fontenoy AM, Nguyen JM, Leux C, et al. Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency. Br J Dermatol. 2011; 165:808–814.
Article
13. Kojima R, Fujiwara T, Matsuda A, Narita M, Matsubara O, Nonoyama S, et al. Factors associated with steroid phobia in caregivers of children with atopic dermatitis. Pediatr Dermatol. 2013; 30:29–35.
Article
14. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1980; 60:Suppl 92. 44–47.
15. Charman CR, Venn AJ, Williams HC. The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients perspective. Arch Dermatol. 2004; 140:1513–1519.
16. Charman CR, Venn AJ, Ravenscroft JC, Williams HC. Translating Patient-Oriented Eczema Measure (POEM) scores into clinical practice by suggesting severity strata derived using anchor-based methods. Br J Dermatol. 2013; 169:1326–1332.
Article
17. Burrichter A, Schlippe AV, Szczepanski R. Kortisonangst bei Asthma bronchiale Eine Elternbefragung [Fear of cortisone in bronchial asthma. A parent survey]. Monatsschr Kinderh. 2006; 154:979–985.
18. Ohya Y, Williams H, Steptoe A, Saito H, Iikura Y, Anderson R, et al. Psychosocial factors and adherence to treatment advice in childhood atopic dermatitis. J Invest Dermatol. 2001; 117:852–857.
Article
19. Fukaya M. Why do patients with atopic dermatitis refuse to apply topical corticosteroids? Dermatology. 2000; 201:242–245.
Article
20. Bewley A. Dermatology Working Group. Expert consensus: time for a change in the way we advise our patients to use topical corticosteroids. Br J Dermatol. 2008; 158:917–920.
Article
21. Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007; 157:645–648.
Article
22. Rao VU, Apter AJ. Steroid phobia and adherence--problems, solutions, impact on benefit/risk profile. Immunol Allergy Clin North Am. 2005; 25:581–595.
Article
23. Hengge UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006; 54:1–15. quiz 16-18
Article
24. Cook LJ, Freinkel RK, Zugerman C, Levin DL, Radtke R. Iatrogenic hyperadrenocorticism during topical steroid therapy: assessment of systemic effects by metabolic criteria. J Am Acad Dermatol. 1982; 6:1054–1060.
Article
25. Kwon HJ, Kim YJ, Park SB, Yu DS, Kim JW. Study of atopic dermatitis information on the internet in Korea. Korean J Dermatol. 2006; 44:137–140.
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