title: Topical Corticosteroid Misuse: The Scenario in Patients Attending a Tertiary Care Hospital in New Delhi.
abstract: BACKGROUND
  Irrational use of Topical Corticosteroid (TC) is quite common in India due to unrestricted availability and use of TC not only by general public but also by physicians and chemists due to quick relief of symptoms in different dermatological conditions.
  
  
  OBJECTIVE
  The present study was conducted to evaluate and analyse the prevalence of misuse of TC and the causes behind misuse of TC among patients in a dermatology outpatient department in New Delhi.
  
  
  METHODS
  This was a cross-sectional observational questionnaire based study conducted over a period of 5 months (1stJune 2015 to 30thNovember 2015). Patients were questioned and assessed for misuse of TCs in terms of indication, dose, frequency, duration and source of recommendation of TC.
  
  
  RESULTS
  During the study period, 256 (11.77%) patients presented with inappropriate use of TC out of 2174 patients attending OPD of dermatology unit of a government hospital. A total of 250 patients presented with adverse effects of TC resulting from the misuse of these drugs. There were 60%female patients and 20-29 years (38%) was the most common age group affected. We found fungal infection (38%) was the most common reason of abuse followed by facial acne (29%) and lightening of skin colour (8.4%). Friends and family (33.2%) were found to be the most influencing factors for misuse of TC. Betamethasone (72.8%) was the most commonly used TC preparation and tinea incognito (26.4%) followed by facial acne (25.6%) were the most common side effect experienced.
  
  
  CONCLUSIONS
  Outcome of the misuse of TC could be dreadful and the cause for same lies at all levels- patients, family, physicians and the regulatory authorities.
authors.affiliation: Senior Resident, Department of Pharmacology, North DMC Medical College, Hindu Rao Hospital , New Delhi, Delhi, India .
authors.forename: Santwana
authors.initials: S
authors.lastname: Mahar
authors.affiliation: Assistant Professor, Department of Dermatology, North DMC Medical College, Hindu Rao Hospital , New Delhi, Delhi, India .
authors.forename: Khushbu
authors.initials: K
authors.lastname: Mahajan
authors.affiliation: Senior Resident, Department of Dermatology, North DMC Medical College, Hindu Rao Hospital , New Delhi, Delhi, India .
authors.forename: Swati
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Professor, Department of Dermatology, North DMC Medical College, Hindu Rao Hospital , New Delhi, Delhi, India .
authors.forename: Hemanta Kumar
authors.initials: HK
authors.lastname: Kar
authors.affiliation: Professor, Department of Pharmacology, North DMC Medical College, Hindu Rao Hospital , New Delhi, Delhi, India .
authors.forename: Swapan Kumar
authors.initials: SK
authors.lastname: Bhattacharya
keywords: Adverse effects; Irrational use; Over the counter