Topical corticosteroid phobia in parents of pediatric patients with atopic dermatitis: a multicentre survey

Maya El Hachem, Francesco Gesualdo, Giampaolo Ricci, Andrea Diociaiuti, Loredana Giraldi, Orsola Ametrano, Corrado Occella, Anna Belloni Fortina, Mirella Milioto, Fabio Arcangeli, Oriana Simonetti, Simona Giancristoforo, Elisabetta Calamelli, Carlo Mazzatenta, Iria Neri

Research output: Contribution to journalArticle


BACKGROUND: Families of children affected with atopic dermatitis (AD) often report fear and anxiety regarding treatment with topical corticosteroids (TCS), which may lead to reduced compliance. The objective of our study was to measure, through a standardized questionnaire, fear of TCS in families of pediatric patients with AD and to identify items associated with fear.

METHODS: Families of pediatric patients with AD were enrolled in 9 Italian centers of pediatric dermatology. Enrolled parents were invited to fill in a questionnaire including questions on sociodemographic and clinical characteristics and 3 sets of questions on corticosteroid phobia (general fear, specific fears, behaviours regarding TCS). Determinants of the level of general fear were investigated through multivariable analysis.

RESULTS: A total of 300 outpatients with AD were enrolled. Most parents (80%) had a high instruction level. Eighty-one percent reported to have a certain amount of fear of TCS. At the multivariable analysis, fear of TCS was associated with the following items: believing that TCS treatment advantages do not overweight disadvantages (P = 0.011); believing that TCS may be dangerous independently from the specific side effect (P < 0.001). Moreover, TCS fear was associated with fear of applying too much cream (P = 0.001).

CONCLUSION: TCS phobia is widespread among Italian families of children with AD. Fear of TCS is associated with fear of applying too much cream, thus increasing the risk of poor compliance and treatment failure. Therapeutic education of families on the use of TCS should be implemented.

Original languageEnglish
Pages (from-to)22
JournalItalian Journal of Pediatrics
Issue number1
Publication statusPublished - Feb 28 2017



  • Administration, Cutaneous
  • Child
  • Dermatitis, Atopic
  • Dermatologic Agents
  • Dermatology
  • Female
  • Glucocorticoids
  • Humans
  • Italy
  • Male
  • Outpatients
  • Parents
  • Patient Education as Topic
  • Phobic Disorders
  • Surveys and Questionnaires
  • Treatment Outcome
  • Journal Article
  • Multicenter Study

Cite this

El Hachem, M., Gesualdo, F., Ricci, G., Diociaiuti, A., Giraldi, L., Ametrano, O., Occella, C., Fortina, A. B., Milioto, M., Arcangeli, F., Simonetti, O., Giancristoforo, S., Calamelli, E., Mazzatenta, C., & Neri, I. (2017). Topical corticosteroid phobia in parents of pediatric patients with atopic dermatitis: a multicentre survey. Italian Journal of Pediatrics, 43(1), 22.