Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency

Aubert-Wastiaux, Hélène; Moret, L.; Rhun, Anne Le; Fontenoy, Anne-Maëlle; Nguyen, Jaidyn; Leux, Christophe; Miséry, Laurent; Young, Paul R.; Chastaing, M.; Danou, Nathalie; Lombrail, Pierre; Boralévi, F.; Lacour, Jean‐Philippe; Mazereeuw‐Hautier, J.; Stalder, J.‐F.; Barbarot, S.

doi:10.1111/j.1365-2133.2011.10449.x

Cited by 222 publications

(235 citation statements)

References 23 publications

(30 reference statements)

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“…Although this phobia does not correlate with AD severity, it does lead to undertreatment of the skin disease. 42,43 Topical steroids are classified according to their potency, ranging from class VII (low potency) to class I (super potent; Table 2). Class I medications are 1800 times more potent than the least potent class VII medications.…”

Section: Topical Antiinflammatory Medicationsmentioning

confidence: 99%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

103

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Atopic dermatitis is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It can be frustrating for pediatric patients, parents, and health care providers alike. The pediatrician will treat the majority of children with atopic dermatitis as many patients will not have access to a pediatric medical subspecialist, such as a pediatric dermatologist or pediatric allergist. This report provides up-to-date information regarding the disease and its impact, pathogenesis, treatment options, and potential complications. The goal of this report is to assist pediatricians with accurate and useful information that will improve the care of patients with atopic dermatitis. Pediatrics 2014;134:e1735-e1744Atopic dermatitis (AD), commonly referred to as eczema, is a chronic, relapsing, and often intensely pruritic inflammatory disorder of the skin. A recent epidemiologic study using national data suggested that the pediatric prevalence is at least 10% in most of the United States. 1 AD primarily affects children, and disease onset occurs before the ages of 1 and 5 years in 65% and 85% of affected children, respectively. 1 The number of office visits for children with AD is increasing. 2 Up to 80% of children with AD are diagnosed and managed by primary care providers, often pediatricians. 3 Although medical subspecialists, such as pediatric dermatologists and/or pediatric allergists, may be suited to provide more advanced care for children with AD, lack of a sufficient number of such physicians, particularly pediatric dermatologists, 4 likely means the burden of AD care will continue to fall to primary care providers. Although consensus guidelines and practice parameters regarding the management of AD in children have been published, 5-10 considerable variability persists in clinical practice, particularly regarding the roles that bathing, moisturizing, topical medications, and allergies play in management. Inconsistencies in opinion and treatment approach as well as the chronic and relapsing nature of AD can lead to frustration for the patient, family, and primary care providers when managing AD. STATEMENT OF THE PROBLEMNew data support the theory that AD results from primary abnormalities of the skin barrier, 11 suggesting that skin-directed management of AD is of paramount importance. This clinical report reviews AD and provides an up-to-date approach to skin-directed management that is based on pathogenesis. Effectively using this information to create treatment plans

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Section: Topical Antiinflammatory Medicationsmentioning

confidence: 99%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

103

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“…Patients and especially parents of small children need to be educated about the safety and efficacy of topical corticosteroids and their use 18 . In the study by Charman et al, 24% of patients refused the use of topical steroids 11 , and in another study by Aubert-Wastiaux et al, 11 years later, 36% of patients refused topical steroid application 19 . In our study, 21% of AD patients felt uncertain about using topical steroid preparations and had little knowledge about their side effects.…”

Section: Discussionmentioning

confidence: 99%

Importance of Educational Intervention and Parental Knowledge on Atopic Dermatitis in Children

Kotrulja¹

2016

ACC

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SUMMARY -Atopic dermatitis (AD) is a chronic relapsing, inflammatory skin disease. Failure to treat AD successfully can often be directly linked to poor treatment adherence as a result of the lack of information about the disease and basic principles of treatment. Several studies have found that making patients active participants in their care through information and education is a successful treatment strategy in AD. The aim of this study was to evaluate parental knowledge on AD and to stress the importance of therapeutic educational program in long term management and control of the disease. We carried out a short questionnaire-based study among 238 parents of children with AD regarding their knowledge on the etiology and treatment of AD. Our results showed that 21% of the participants reported corticophobia and were concerned about systemic absorption affecting the child's growth and development even after short application. In children with AD who have food hypersensitivity, 14% of parents thought that a small amount of food allergen could be beneficial in achieving tolerability. The role of interdisciplinary educational program is to explain the epidemiology and pathogenesis of AD, as well as concomitant atopy related diseases and to teach parents about the importance of appropriate skin care.

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“…1,2 Most authors of the drug company-sponsored PETITE study have declared conflicts of interest, and we note several respective issues in the published report of this study that make it a good example of "spin. "…”

mentioning

confidence: 95%