UNLABELLED: Topical corticosteroids (CSs) are the mainstay of treatment for eczema but CS phobia and fears are prevalent and influence therapeutic efficacy. AIM: To quantify if CS acceptability and fear affect patients' quality-of-life (QoL). METHODS: Patients with eczema managed in the pediatric dermatology outpatient clinic of a university hospital were surveyed. Nottingham Eczema Severity Score (NESS) for severity, Children's Dermatology Life Quality Index (CDLQI) for QoL, CS fear, acceptability and reported frequency of CS use were measured with quantified questions. RESULTS: CS fears were prevalent among parents and caregivers of patients with eczema. Fifty-eight percent of parents reported general acceptability of CS as being very good or good, and many applied CS to their child regularly every week. However, >40% of parents reported CS fear "always" or "often", 41% reported that they "always" or "often" apply CS only when eczema got worse, 57% would discuss CS fear with their doctors, 30% would request CS-sparing medications and 14% "always" or "often" use traditional Chinese herbal medicine. Fears were predominantly interpersonal and less often iatrogenic in nature. Skin problems were the most concerned side effects of CS. CS acceptability, frequency of CS usage, CS fear and usage of alternative medications were independent domains in eczema management: CS fears correlated with CDLQI; CS usage frequency correlated with NESS and negatively with parental education; and CS acceptability correlated with parental education. Ordinal logistic regressions showed worse QoL was associated with more CS fear (odds ratio: 1.092 [95% CI: 1.023-1.165], p = 0.008). CONCLUSIONS: The extent of CS fears is independent of CS acceptability, but correlates with patients' QoL. Desensitization of parental CS fears should be integral part of eczema education and therapeutics in order to improve therapeutic efficacy and patients' QoL.
UNLABELLED: Topical corticosteroids (CSs) are the mainstay of treatment for eczema but CS phobia and fears are prevalent and influence therapeutic efficacy. AIM: To quantify if CS acceptability and fear affect patients' quality-of-life (QoL). METHODS:Patients with eczema managed in the pediatric dermatology outpatient clinic of a university hospital were surveyed. Nottingham Eczema Severity Score (NESS) for severity, Children's Dermatology Life Quality Index (CDLQI) for QoL, CS fear, acceptability and reported frequency of CS use were measured with quantified questions. RESULTS: CS fears were prevalent among parents and caregivers of patients with eczema. Fifty-eight percent of parents reported general acceptability of CS as being very good or good, and many applied CS to their child regularly every week. However, >40% of parents reported CS fear "always" or "often", 41% reported that they "always" or "often" apply CS only when eczema got worse, 57% would discuss CS fear with their doctors, 30% would request CS-sparing medications and 14% "always" or "often" use traditional Chinese herbal medicine. Fears were predominantly interpersonal and less often iatrogenic in nature. Skin problems were the most concerned side effects of CS. CS acceptability, frequency of CS usage, CS fear and usage of alternative medications were independent domains in eczema management: CS fears correlated with CDLQI; CS usage frequency correlated with NESS and negatively with parental education; and CS acceptability correlated with parental education. Ordinal logistic regressions showed worse QoL was associated with more CS fear (odds ratio: 1.092 [95% CI: 1.023-1.165], p = 0.008). CONCLUSIONS: The extent of CS fears is independent of CS acceptability, but correlates with patients' QoL. Desensitization of parental CS fears should be integral part of eczema education and therapeutics in order to improve therapeutic efficacy and patients' QoL.
Authors: Kam Lun Hon; Yan Min Bao; Kate C Chan; Kin Wai Chau; Rong-Shan Chen; Kun Tat Gary Cheok; Wa Keung Chiu; Li Deng; Chun-Hui He; Kin Mui Ieong; Jeng Sum C Kung; Ping Lam; Shu Yan David Lam; Qun Ui Lee; So Lun Lee; Ting Fan Leung; Theresa N H Leung; Lei Shi; Ka Ka Siu; Wei-Ping Tan; Maggie Haitian Wang; Tak Wai Wong; Bao-Jing Wu; Ada Y F Yip; Yue-Jie Zheng; Daniel K Ng Journal: World J Pediatr Date: 2018-07-25 Impact factor: 2.764
Authors: David Luk; Kam Lun Ellis Hon; Maria Victoria C Dizon; Kin-Fon Leong; Yong-Kwang Tay; Mark Jean-Aan Koh; Nisha Suyien Chandran; Siriwan Wananukul; Susheera Chatproedprai; Thomas Luger Journal: Dermatol Ther (Heidelb) Date: 2020-12-12
Authors: Eric L Simpson; Amy S Paller; Mark Boguniewicz; Lawrence F Eichenfield; Steven R Feldman; Jonathan I Silverberg; Sarah L Chamlin; Lee T Zane Journal: Dermatol Ther (Heidelb) Date: 2018-10-22