Topical Corticosteroid Phobia in Atopic Dermatitis: A Systematic Review

Area of Science:

• Dermatology
• Psychology
• Public Health

Background:

• Topical corticosteroid (TCS) phobia involves negative patient and caregiver beliefs about TCSs.
• This phobia is a potential cause of treatment failure in atopic dermatitis.
• Existing literature on TCS phobia is sparse.

Purpose of the Study:

• To systematically review the nomenclature, prevalence, origins, and impact on treatment adherence of TCS phobia.
• To assess the current state of research on TCS phobia in atopic dermatitis.

Main Methods:

• A comprehensive literature search was performed across major databases (Ovid, PubMed, Web of Science) from 1946 to 2016.
• Studies assessing TCS phobia in atopic dermatitis patients or caregivers were included.
• Study quality was assessed using a modified Oxford Centre for Evidence-Based Medicine criteria.

Main Results:

• 16 studies met inclusion criteria, all cross-sectional.
• TCS phobia prevalence varied widely (21.0% to 83.7%), with inconsistent definitions.
• Studies showed significantly higher nonadherence rates in patients with TCS phobia (49.4% vs 14.1% and 29.3% vs 9.8%).

Conclusions:

• TCS phobia is common across cultures and linked to poor treatment adherence.
• Interventions targeting patient education and information sources could improve adherence.
• Standardized definitions and assessment methods are crucial for future research.