Topical Corticosteroid Abuse in Nepal: Scenario

Jha, Anil Kumar; Karki, Subekcha; Jha, Sagar Mani

doi:10.1007/978-981-10-4609-4_18

Cited by 3 publications

(4 citation statements)

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“…Topical corticosteroids misuse for various dermatological conditions is a common problem in India and Nepal. 2,3,6 A nationwide Outpatient Department (OPD) based multi-centric study in India, among patients having facial dermatosis, 14.8% were using topical steroid, out of which 90.5% had various side effects due to steroid. 59.3% of those applying were non-prescriptional out of which 90.3% were potent/superpotent steroids.…”

Section: Discussionmentioning

confidence: 99%

“…Topical Corticosteroids are over the counter and cheaper drugs available in every medical stores in Nepal and India and often misused for treatment of Dermatophytic infections, Eczemas, Acne, undiagnosed skin rashes and as fairness cream by non-registered practitioners/ chemist. 2,3,4 In a Tertiary hospital in Nepal, almost 74.4 % had used topical steroid cream on face from recommendation of friends/pharmacist or from over the counter purchase. 5 In 2014-15 there was a sale worth $234 million in India which accounted for almost 82% of total dermatological product sale in the country.…”

Section: Introductionmentioning

confidence: 99%

“…5 In 2014-15 there was a sale worth $234 million in India which accounted for almost 82% of total dermatological product sale in the country. 2,3 Topical corticosteroids have various local side effects (skin atrophy, erythema, telangeictasia, acneiform eruptions, hypertrichosisetc) and rarely systemic side effects (suppression of hypothalamo pituitary adrenal axis, iatrogenic cushing syndrome, growth retardation etc.) on long term use at supraphysiological dosage.…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic Cushing Syndrome due to Application of Potent Topical Corticosteroid: A Case Report

Bhusal

Aryal

Bhattarai

et al. 2019

Nepal J Dermatol Venereol & Leprol

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Corticosteroids are over the counter and cheaper drugs available in every medical stores in Nepal. Iatrogenic Cushing syndrome due to topical steroids application is a very rare phenomenon in adults.A 32 year female from Janakpur presented with complaints of swelling of face, weight gain, excessive facial hair and fatigue since two years that gradually increased over last one year. She had a past medical history of on and off application of multiple potent topical corticosteroids for disseminated Tinea infection. She was obese with moon facies, buffalo hump and multiple striae over her abdomen. Her blood pressure was raised and her blood sugar was in pre-diabetic range. Laboratory studies were consistent with iatrogenic Cushing syndrome. Patient recovered after discontinuation of topical corticosteroids and treatment with antifungals.Although iatrogenic Cushing syndrome following application of topical corticosteroid is a rare phenomenon in adults, this can happen in a setup like ours where corticosteroids are prescribed as over the counters and patients have very little knowledge about their use. Therefore, we emphasize that patients and pharmacist should be well educated about the consequences of their prolong application and their side effects

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Iatrogenic Cushing Syndrome due to Application of Potent Topical Corticosteroid: A Case Report

Bhusal

Aryal

Bhattarai

et al. 2019

Nepal J Dermatol Venereol & Leprol

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“…10 The situation is no different in Nepal. 11,12 Present scenario is such that the textbook recommended dosage and duration of antifungal treatment for the said infection is largely ineffective. 8 Dermatologists throughout the country encounter many such cases of dermatophytosis which are not responding to conventional dosage and duration of treatment with frustration in the patient and the treating physician.…”

Section: Introductionmentioning

confidence: 99%

Health Seeking Behavior and Cost of Care of Chronic Dermatophytosis: A Hospital-Based Cross-Sectional Study

Joshi

Shrestha

Timothy³

et al. 2020

Nep. Med. Coll. J.

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Recent trend in onslaught of chronic and recurrent dermatophytosis not amenable to conventional dose and duration of antifungal agents has been observed in Nepal and India. The major factor implicated behind this surge is use of over-the-counter fixed drug combination containing topical steroids. This study aimed to examine the health seeking behavior, pattern of drug use and cost of care of chronic dermatophytosis in Nepalese population. Ninety-one patients with the diagnosis of chronic dermatophytosis of skin willing to participate in the study were recruited in a hospital-based, cross-sectional study. Information regarding demographic profile, health seeking behavior and cost incurred in the treatment of their dermatophytosis were recorded in a preset proforma. Mean age of study population was 30.49±13.50 years with M:F ratio of 2.25:1. Mean duration of illness was 20.68±6.44 months, with groin as the initial site of involvement in nearly half of cases. Commonest diagnoses were extensive dermatophytosis, followed by tinea cruris et corporis and tinea cruris. Nearly three-forth of patients reported seeking advice from local pharmacy and two-third reported using steroid containing topical agents for their skin problem. On an average, patients spent NPR 6,488.70 in a six months period and 3.03% of their income in the treatment of chronic dermatophytosis. This study highlighted the tendency of patients to seek advice from pharmacy dispensers, use of topical steroid containing agents in chronic dermatophytosis and substantial financial burden borne by patients in the treatment of the condition.

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