Up to four in five patients with atopic dermatitis or their carers show “phobia” to topical corticosteroids, according to a meta-analysis of 16 studies, which suggests that steroid phobia doubles non-adherence rates.

The prevalence of phobia to topical corticosteroids ranged from 21 to 84 per cent in the studies included in the meta-analysis, but their definition of phobia differed markedly, ranging from concern to irrational fear. Skin thinning and effects on growth and development were the commonest concerns expressed by patients or their carers.

The authors suggest targeting people with steroid phobia but say that additional research, using standardised definitions and assessments, is needed to better characterise steroid phobia and evaluate interventions.

JAMA Dermatol doi: 10.1001/jamadermatol. 2017.2437

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