title: Factors associated with steroid phobia in caregivers of children with atopic dermatitis.
abstract: Topical corticosteroids (TCS) are first-line therapeutic agents for atopic dermatitis (AD). Some patients express irrational fear and anxiety about using TCS, which leads to poor outcomes for AD. Although it is important to understand the factors underlying steroid phobia so that its effects can be minimized, few studies have addressed this subject. Here, we used a questionnaire to investigate predictive factors for steroid phobia in the caregivers (usually mothers) of children with AD. We studied 436 children with AD (mean age 47.6 mos, range 2-236 mos) who newly visited our AD outpatient unit. The caregivers were asked to complete a medical history questionnaire regarding AD. Steroid phobia was analyzed for correlations with other patient and caregiver variables. Overall, 38.3% of the caregivers were reluctant to use TCS on their children's skin. Patient characteristics female sex (odds ratio [OR] = 1.85 vs male; p = 0.005), child's paternal history of AD (OR = 1.94; p = 0.03), and frequent changing of clinics (OR = 1.25; p = 0.03) were predictive factors for steroid phobia. AD severity did not correlate with steroid phobia. Our findings suggest that greater attention to the patient's sex and clinical background of patients with AD is important to the success of AD therapy, regardless of AD severity.
authors: Division of Allergy, National Research Institute for Child Health and Development, Tokyo, Japan. rkojima@nch.go.jp
authors: Reiji
authors: R
authors: Kojima
authors: Takeo
authors: T
authors: Fujiwara
authors: Akio
authors: A
authors: Matsuda
authors: Masami
authors: M
authors: Narita
authors: Osamu
authors: O
authors: Matsubara
authors: Shigeaki
authors: S
authors: Nonoyama
authors: Yukihiro
authors: Y
authors: Ohya
authors: Hirohisa
authors: H
authors: Saito
authors: Kenji
authors: K
authors: Matsumoto
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000367:Age Factors; D000553:Ambulatory Care; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010698:Phobic Disorders; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones