Corticosteroid phobia tied to poor treatment adherence in chronic hand eczema

Topical corticosteroid (TCS) phobia (TOPICOP) commonly exists among patients with chronic hand eczema (CHE) and often leads to poor treatment adherence, suggests a recent study.

A total of 927 patients with CHE from the Danish Skin Cohort completed a questionnaire, including the TOPICOP scale and Medication Adherence Report Scale, with a response rate of 69.2 percent.

Majority of the respondents (75.5 percent) totally or almost agreed that TCS damaged the skin, while nearly half (48.9 percent) totally or almost agreed that TCD would affect their future health. In addition, 36.3 percent expressed some degree of fear of TCS despite being unaware of any TCS-related risks.

Because of such fear, many patients (77.9 percent) always or often stop treatment as soon as possible, while others (54.8 percent) always or often wait as long as possible before initiating treatment. Moreover, 38.8 percent of patients reported taking less medicine than prescribed, and 54.0 percent had ceased treatment for a certain period.

Of note, increasing corticosteroid phobia significantly correlated with reduced treatment adherence (p=0.004).

This study was limited by the nonvalidation of TOPICOP in patients with CHE.

“TOPICOP is associated with poor treatment adherence and is common among patients with skin disease,” the researchers said. “Knowledge about corticosteroid phobia and treatment adherence among patients with CHE is limited.”