title: Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency.
abstract: BACKGROUND
  Topical corticosteroids remain the mainstay of atopic dermatitis therapy. Many atopic dermatitis therapeutic failures appear to be attributable to poor adherence to treatment due to topical corticosteroid phobia.
  
  
  OBJECTIVE
  To assess the facets, origins and frequency of fear of topical corticosteroid use among patients with atopic dermatitis.
  
  
  METHODS
  A questionnaire comprising 69 items, generated from information gathered during interviews with 21 patients and 15 health professionals, was given to consecutive patients consulting at the outpatient dermatology departments of five regional university hospitals or with 53 dermatologists in private practice.
  
  
  RESULTS
  A total of 208 questionnaires were analysed (including 144 from parents and 87 from adult patients, 27 of whom were also parents); 80·7% of the respondents reported having fears about topical corticosteroids and 36% admitted nonadherence to treatment. A correlation was found between topical corticosteroid phobia and the need for reassurance, the belief that topical corticosteroids pass through the skin into the bloodstream, a prior adverse event, inconsistent information about the quantity of cream to apply, a desire to self-treat for the shortest time possible or poor treatment adherence. Topical corticosteroid phobia was not correlated with atopic dermatitis severity.
  
  
  CONCLUSIONS
  Topical corticosteroid phobia is a genuine and complex phenomenon, common among French patients with atopic dermatitis, that has an important impact on treatment compliance.
authors.affiliation: Department of Dermatology, CHU Hôtel-Dieu, 1 place Alexis Ricordeau, 44035 Nantes Cedex 1, France. helene.aubert.wastiaux@gmail.com
authors.forename: H
authors.initials: H
authors.lastname: Aubert-Wastiaux
authors.forename: L
authors.initials: L
authors.lastname: Moret
authors.forename: A
authors.initials: A
authors.lastname: Le Rhun
authors.forename: A M
authors.initials: AM
authors.lastname: Fontenoy
authors.forename: J M
authors.initials: JM
authors.lastname: Nguyen
authors.forename: C
authors.initials: C
authors.lastname: Leux
authors.forename: L
authors.initials: L
authors.lastname: Misery
authors.forename: P
authors.initials: P
authors.lastname: Young
authors.forename: M
authors.initials: M
authors.lastname: Chastaing
authors.forename: N
authors.initials: N
authors.lastname: Danou
authors.forename: P
authors.initials: P
authors.lastname: Lombrail
authors.forename: F
authors.initials: F
authors.lastname: Boralevi
authors.forename: J P
authors.initials: JP
authors.lastname: Lacour
authors.forename: J
authors.initials: J
authors.lastname: Mazereeuw-Hautier
authors.forename: J-F
authors.initials: JF
authors.lastname: Stalder
authors.forename: S
authors.initials: S
authors.lastname: Barbarot
mesh_terms: D000279:Administration, Cutaneous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000523:psychology*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D015999:Multivariate Analysis; D010353:Patient Education as Topic; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents