Abstract
BackgroundFamilies of children affected with atopic dermatitis (AD) often report fear and anxiety regarding treatment with topical corticosteroids (TCS), which may lead to reduced compliance. The objective of our study was to measure, through a standardized questionnaire, fear of TCS in families of pediatric patients with AD and to identify items associated with fear.MethodsFamilies of pediatric patients with AD were enrolled in 9 Italian centers of pediatric dermatology. Enrolled parents were invited to fill in a questionnaire including questions on sociodemographic and clinical characteristics and 3 sets of questions on corticosteroid phobia (general fear, specific fears, behaviours regarding TCS). Determinants of the level of general fear were investigated through multivariable analysis.ResultsA total of 300 outpatients with AD were enrolled. Most parents (80%) had a high instruction level. Eighty-one percent reported to have a certain amount of fear of TCS. At the multivariable analysis, fear of TCS was associated with the following items: believing that TCS treatment advantages do not overweight disadvantages (P = 0.011); believing that TCS may be dangerous independently from the specific side effect (P < 0.001). Moreover, TCS fear was associated with fear of applying too much cream (P = 0.001).ConclusionTCS phobia is widespread among Italian families of children with AD. Fear of TCS is associated with fear of applying too much cream, thus increasing the risk of poor compliance and treatment failure. Therapeutic education of families on the use of TCS should be implemented.
Highlights
Families of children affected with atopic dermatitis (AD) often report fear and anxiety regarding treatment with topical corticosteroids (TCS), which may lead to reduced compliance
With the present multicenter study, we investigated prevalence and determinants of steroid phobia in a large group of Italian families of pediatric patients affected by AD
Study design This is a multicenter, cross-sectional study conducted in the dermatology units and general pediatric units of 9 pediatric centers located in 9 Italian cities (Ancona, Bologna, Cesena, Genoa, Lucca, Naples, Padova, Palermo, Rome, Bologna)
Summary
Families of children affected with atopic dermatitis (AD) often report fear and anxiety regarding treatment with topical corticosteroids (TCS), which may lead to reduced compliance. Atopic dermatitis (AD) is a common chronic, pruritic, inflammatory skin disease, mostly affecting children, with heterogeneous lifetime prevalence figures, ranging worldwide from 8 to 18% [1]. Its exact pathogenesis still remains unclear, it is well established that AD depends on a combination of genetic and environmental factors. In patients with AD, a genetically determined alteration of the skin barrier allows penetration of environmental factors, El Hachem et al Italian Journal of Pediatrics (2017) 43:22. With the present multicenter study, we investigated prevalence and determinants of steroid phobia in a large group of Italian families of pediatric patients affected by AD
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