Topical Corticosteroid Phobia in Childhood Atopic Dermatitis: A Study Using the TOPICOP Score

TL;DR

This study finds that fear of using corticosteroids is common among parents of children with eczema in Slovenia, especially in severe cases and single-parent households.

Contribution

The first study to evaluate topical corticosteroid phobia in Slovenian parents and identify single-parent households as a novel contributing factor.

Findings

Corticosteroid phobia was highest in parents of children with more severe eczema.

Parents in single-parent households showed significantly higher phobia levels.

Online information about corticosteroid dangers was strongly linked to higher phobia scores.

Abstract

Topical corticosteroid phobia (CSP) is a significant barrier to the effective treatment of atopic dermatitis (AD). This is the first study to evaluate the CSP prevalence among parents of children with AD in Slovenia and to identify contributing factors.

We conducted a cross‐sectional study between March 2021 and December 2023. Parents of children with dermatologist‐confirmed AD, aged 3 months to 18 years, completed the validated TOPICOP questionnaire, supplemental questions and the (F)DLQI questionnaire. The SCORAD index was used to assess the severity of their children’s AD disease. Statistical analyses included the Shapiro–Wilk test, two‐tailed independent t‐test, ANOVA, followed by Tukey post hoc testing and the Pearson correlation coefficient.

Among 117 parents (81.2% mothers), the mean TOPICOP score was 48.2% (SD 15.1). Fear was the highest‐scoring TOPICOP domain (53.7%). CSP was significantly higher in parents of children with more severe AD based on SCORAD (p = 0.033) and in families with higher (F)DLQI scores (r = 0.311, p = 0.002). Notably, our results suggest that parents of children in single‐parent households had significantly higher CSP (p = 0.035), a novel finding that warrants cautious interpretation due to the small subgroup size. Information obtained online about the potential dangers of topical corticosteroids (TCS) correlated with higher CSP (p < 0.001).

CSP is prevalent among Slovenian parents of children with AD and is particularly pronounced in cases of more severe disease and single‐parent households, a novel and previously undescribed finding. Given that CSP is often influenced by nonmedical information sources, structured education and support by all healthcare providers is essential.

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