Topical Corticosteroid Phobia Among Atopic Eczema Patients And Their Caregivers: Survey In Two Dermatology Outpatient Clinics In Malaysia

ABSTRACT

Introduction: Steroid phobia has been recognized as a hindrance to successful treatment in patients with atopic eczema. Data on this phenomenon is lacking in Malaysia. This study investigates the prevalence and reasons for topical corticosteroid phobia in patients with atopic eczema and their caregivers. Methods: A questionnaire-based study was conducted in both children and adult patients suffering from atopic eczema in two government dermatology clinics at Hospital Kuala Lumpur and Hospital Kota Bharu between May and July 2011. Results: Of the 77 respondents, 39% were worried about using topical corticosteroids for their eczema with 13% totally avoiding steroids. The most common reason for this fear was concern about skin thinning (27.3%) followed by concern on changes in skin colour (14.3%), scarring (13%) and stretch marks (13%). Steroid phobia was significantly higher in those with tertiary education (p=0.005). Conclusion: Steroid phobia appears to be a significant problem in Malaysia especially in those with higher educational background. Despite these concerns, the patients’ compliance to topical corticosteroids is still reasonably good.