Topical steroid therapy in atopic dermatitis in theory and practice

INTRODUCTION Topical glucocorticosteroids (GCSs) are commonly used in treatment of atopic dermatitis (AD). AIM To assess the patients' compliance with the recommended instructions of the therapy. MATERIAL AND METHODS The study involved 141 adult AD patients. The clinical course of AD and its treatment with GCSs during the last year were analysed. RESULTS In the periods of exacerbation the lesions involved 10-50% of the skin surface area. Outpatient treatment in specialised dermatological and/or allergology clinics was given to 93% of the study subjects. Sixty-five out of 141 patients regularly attended medical control examinations. Glucocorticosteroids, mostly very potent ones (70.2%), were applied to all the subjects. 66.7% of patients obtained no information about their medications' anti-inflammatory potential. The substances were applied more frequently than twice daily by 36.4% of the patients. Seventy-two of 141 subjects applied GCSs both temporarily and in the long-term treatment, for 8.3 weeks on average. In the long-term treatment, in which very potent GCSs predominated (70.7%), no one used intermittent therapy. One hundred and thirty patients introduced their own modifications to the instructions concerning GCSs use, among which 37.7% changed the site of application, 58.5% prolonged the duration of application and 49.5% shortened it or occasionally temporarily withdrew the prescribed drug. None of the patients knew the fingertip unit method of dose assessment. Apart from steroid therapy, 56.7% of the patients carried out regular care treatment. CONCLUSIONS The AD patients need to be thoroughly educated by the medical staff in the topical GCSs therapy in atopic dermatitis.