Corticosteroid Phobia among Individuals with Chronic Hand Eczema: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On September 5, 2024, we reported on a study published in the Journal of the American Academy of Dermatology that examined patient-reported outcomes regarding topical corticosteroids (TCSs), and their impact on treatment adherence in patients with chronic hand eczema (CHE).

The study

Researchers assessed the knowledge, beliefs, fears, and behaviors about TCS as well as treatment adherence among patients with CHE from the Danish Skin Cohort study. Participants were included in the current study if they answered 2 questionnaires, including the Topical Corticosteroid Phobia (TOPICOP) scale and Medication Adherence Report Scale (MARS-5). Among a total of 1340 participants with CHE eligible for the study, 927 (69.2%) participants answered both questionnaires and were therefore included in the study. The majority (71.7%) of the cohort were women and the mean age was 55.4 years.

The findings

• 75.5% of participants totally or almost agreed that TCS damage skin, and nearly half (48.9%) totally or almost agreed that TCS would affect their future health.

• 77.9% of participants reported always or often stopping TCS treatment as soon as possible, whereas more than half (54.8%) said they always or often waited as long as possible before starting therapy.

• Using less medicine than was prescribed and stopping TCS therapy during a treatment period was reported by 38.8% and 54% of patients, respectively.

• 36.3% of patients reported some degree of fear of TCS use despite being unaware of any TCS-related risks.

• There was a significant association between low treatment adherence and high corticosteroid phobia (P = .004).

Authors' comment

The results underscore both, "the need for better TCS education among patients with CHE and health care professionals as well as the demand for nonsteroidal treatment alternatives that are both efficacious and have a favorable safety profile."

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