Topical Corticosteroid Misuse: The  Scenario in Patients Attending a Tertiary  Care Hospital in New Delhi

Mahar, Santwana; Mahajan, Khushbu; Agarwal, Swati; Kar, Hemanta Kumar; Bhattacharya, Swapan Kumar

doi:10.7860/jcdr/2016/23419.8986

Cited by 30 publications

(47 citation statements)

References 18 publications

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“…Betamethasone valerate-based medications were most commonly used with friends/relatives as the common source of prescription (33.2%). 16 Furthermore, a case series of tinea incognito resulting from misuse of potent TCs has been reported by Sheth et al, Janney et al, in 100 cases revealed tinea cruris as the most common clinical presentation (44%), whereas 32% of the study population consulted a dermatologist on developing a rash, the majority (68%) used OTC topical medications recommended by pharmacists and friends/relatives, general practitioners. 17 A total of 33 different commercially available OTC preparations were used, were 77.94% of the patients used steroid based preparations in which 63.23% of the patients using these OTC preparations reported to have adverse effects.…”

Section: Discussionmentioning

confidence: 93%

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Observational cross-sectional study to evaluate the effects of self-medication with topical agents used by patients for superficial fungal skin infection at tertiary care hospital in Mumbai

Mahajan¹,

Deshmukh²,

Rawal³

2020

Int J Basic Clin Pharmacol

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Background: Superficial fungal infections of the hair, skin, and nails are a major cause of morbidity in the world and their incidence continues to increase. While self-medication is also one of the major health concerns for health authorities worldwide. The aim of the study was to evaluate the effects of topical agents used by patients for self-medication, to enlisting the topical agents used by patients for self-medication, to ensure by whose suggestion’s patients engaged in self-medication.Methods: It was an observational cross-sectional study which was conducted at the outpatient department (OPD) of dermatology in tertiary care hospital. A detailed history of the participant was recorded regarding topical agents used for self-medication and their effects were documented in a predesigned case record form.Results: The population consisted of 128 males and 87 females. All these 215 participants had used 61 topical agents of different brand names and the majority of were irritant, corticosteroids and antifungal much high in use. Among 215 participants, 111 had temporary relief from the infection and reoccurred after stopping its use. 98 showed aggravation in their infection among which 90 showed effects like irritation, burning and itching at the application site, while 8 participants showed dryness or flaking of skin.Conclusions: Self-medication is widely practiced among patients with a superficial fungal skin infection in Mumbai. A pharmacist was the major source for obtaining these topical agents. We can conclude, there is a need to counsel and discourage patients from self-medication and regulations for dispensing the prescribed drugs should be made stringent.

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Section: Discussionmentioning

confidence: 93%

“…Pharmacists have been a major source for obtaining topical agents (20-78) % in the earlier studies also. 15,16 Hence, educating pharmacists about the adverse effects of irrational use of such topical agents is crucial. While rules for dispensing such medication should be made stringent so that patient would not get easy access to them.…”

Section: Discussionmentioning

confidence: 99%

Observational cross-sectional study to evaluate the effects of self-medication with topical agents used by patients for superficial fungal skin infection at tertiary care hospital in Mumbai

Mahajan¹,

Deshmukh²,

Rawal³

2020

Int J Basic Clin Pharmacol

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“…36 TS'nin kullanımına bağlı oluşabilecek potansiyel yan etkilerin meydana gelmesinde etkili bir diğer faktör, hastaların bu uygulamaya hekim olmayan kişilerin tavsiyesi sonucunda başlamış olmasıdır. [37][38][39] Sharma ve ark. tarafından TS kullanan hastalarda yapılan anket çalışmasında, ilaçların çoğunlukla eczacılar (%35), hasta yakınları (%31) ve kozmetik uzmanları (%11) tarafından önerildiği, yalnızca %15'inin dermatolog olmayan hekimler, %9'unun ise dermatologlar tarafından reçete edildiği gösterilmektedir.…”

Section: Tepeklinikunclassified

“…37 Benzer bir çalışmada da arkadaş ve aile önerisinin bu tür ilaçların kullanımında en etkili faktör olduğu vurgulanmıştır. 38 Diğer bir prospektif ve çok merkezli bir araştırmada, kullanılan ilaçların %59'unun hekim olmayan biri tarafından tavsiye edildiği, bu ilaçların %90'ını güçlü/çok güçlü etkili kortikosteroid ilaçların oluşturduğu ve sonuçta da TS kullanımına bağlı olarak %91 oranında yan etkilerin ortaya çıktığı gösterilmiştir. 39 Güncel tarihli bu çalışmaların sonuçları TS'nin konunun uzmanı olmayan kişiler tarafından önerilmesinin doğru olmadığını, ancak bir hekim ta-rafından reçete edildiğinde doğru doz ve endikasyonda kullanılmasının mümkün olduğunu ortaya koymaktadır.…”

Section: Tepeklinikunclassified

Topical steroids in dentistry: Adverse effects and proposal for application

Gürhan¹,

Güneri²

2019

Yeditepe J Dent

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Topikal, sistemik, inhalasyonel, rektal ve intraartiküler ajanlar olarak kullanılabilen glikokortikoidler genellikle enflamatuvar, alerjik, otoimmün ve neoplastik hastalıkların tedavisinde tercih edilirler. Özellikle bu ajanlardan topikal formda olanlar oral mukozal hastalıklarla ilişkili ağız lezyonlarının tedavisinde kullanılmaktadırlar. Bu nedenle oral mukozal hastalıklarda etkili bir tedavi sağlamak ve aynı zamanda hastaları potansiyel yan etkilerden korumak için diş hekimleri topikal steroidlerin (TS) endikasyonlarını, yan etkilerini ve klinik uygulama şekillerini bilmelidirler. Doğru şekilde kullanıldığında birçok oral mukozal hastalıkta tatmin edici klinik sonuçlar sağlayan TS'nin, hatalı uygulamalar sonucunda iyatrojenik Cushing sendromu, adrenal yetmezlik gibi ciddi komplikasyonlara neden olabileceğine dair birçok çalışma bulunmaktadır. Literatürde, TS'nin hangi dozdan ve uygulama sıklığından sonra sistemik kan dolaşımına katıldığına ilişkin bir görüş birliğine varılamamıştır. Sunulan bu derlemede, son yıllarda diş hekimleri tarafından sıklıkla reçete edilmeye başlayan TS'nin endikasyon ve kontrendikasyonları ile avantaj ve dezavantajlarının yanı sıra, güncel literatür bilgileri ışığında doğru kullanım önerilerinin paylaşılması amaçlanmıştır. Anahtar kelimeler: Diş hekimliği, topikal steroid, yan etki. SUMMARY Glucocorticoids, which are used as topical, systemic, inhalational, rectal and intraarticular agents, are often preferred for treatment of inflammatory, allergic, autoimmune and neoplastic diseases. Especially, topical forms of these agents are used to treat oral lesions associated with oral mucosal diseases. Therefore, dentists must know indications, side effects and application forms of topical steroids (TS) in order to treat oral mucosal diseases effectively, and to protect the patients from potential side effects. There are many studies, suggesting that when TS are used properly, they provide satisfactory clinical results in many oral mucosal diseases; whereas it may lead to serious complications, such as iatrogenic Cushing syndrome and adrenal insufficiency, as a result of inaccurate applications. In the literature, there is no consensus about the posology of TS, which results in the absorption of the TS into systemic circulation. The aims of this review are to offer indications, contraindications, advantages, and disadvantages of TS, which have been frequently prescribed by dentists in recent years, as well as to share suggestions for proper usage of these drugs in accordance with the current information in the literature.

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“…Auf der anderen Seite werden die Ängste verständlich durch eine missbräuchliche Verwendung von topischen Kortikoiden und die daraus entstehenden Nebenwirkungen, wie diverse Fälle aus Indien zeigen [7,8]. Die Ängste gegenüber Cortison und die dargestellten Studienergebnisse decken sich mit einer umfangreichen Literaturrecherche zum Thema «compliance/adherence» von Steve Feldman et al [9].…”

Section: Fazit Für Die Praxisunclassified

Bedenken gegenüber topischen Kortikosteroiden: Zuwendung und Patientenaufklärung sind für Therapietreue essenziell

Gieler¹

2017

Kompass Dermatol

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Hintergrund/Ziele: Bedenken gegenüber topischen Kortikosteroiden (TCC; topical corticosteroid concerns) sind bei Patienten mit atopischer Dermatitis ein wichtiges Thema, das mit mangelnder Therapietreue, entsprechend schlechter Krankheitskontrolle und erhöhten Kosten für das Gesundheitswesen einhergeht. Doch weder die Prävalenz von TCC in einer überschaubareren dermatologischen Patientenpopulation noch die Auswirkungen der Patientenaufklärung zu topischen Kortikosteroiden durch Ärzte sind bekannt. Daher untersuchten wir die Prävalenz, Merkmale und Quellen von TCC in einer dermatologischen Population sowie die Auswirkungen schriftlicher und mündlicher Patientenaufklärung über TCC. Methoden: Insgesamt 643 ambulante Patienten mit verschiedenen Hautkrankheiten beantworteten während der Wartezeit in der Praxis einen Fragebogen mit 12 Items. Vor und nach der Patienteninformation, bestehend aus einer schriftlichen und mündlichen dermatologischen Aufklärung über topische Kortikosteroide (TCS), stuften die Patienten mit TCC das Ausmaß ihrer Bedenken auf einer separaten visuellen Analogskala ein. Ergebnisse: Die TCC-Prävalenz lag bei 41,5%; die Prävalenz TCC-bedingter Non-Adhärenz bei 28,3%. TCC war positiv assoziiert mit einem Lebensalter <60 Jahren, weiblichem Geschlecht, Anwendung von Komplementär- und Alternativmedizin (CAM) sowie Inanspruchnahme von nicht-ärztlicher Gesundheitsberatung. Die stärksten Bedenken bestanden gegenüber Hautatrophie, systemischen Wirkungen und Beeinträchtigungen des Immunsystems. Die häufigsten Quellen von TCC waren negative Berichte in den Medien oder von Angehörigen und Freunden. Sowohl die schriftliche als auch die mündliche Aufklärung reduzierten die TCC signifikant. Die «number needed to benefit from (patient) information» betrug für die Patientenaufklärung etwa 2. Die Non-Responder waren überdurchschnittlich häufig weiblich, TCS-unerfahren, CAM-Anwender und von mittlerem Bildungsniveau. Schlussfolgerungen: TCC sind in bei dermatologischen Patienten sehr weit verbreitet. Die Aufklärung des Patienten kann die TCC in nahezu jedem zweiten Fall reduzieren.

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Topical Corticosteroid Misuse: The Scenario in Patients Attending a Tertiary Care Hospital in New Delhi

Cited by 30 publications

References 18 publications

Observational cross-sectional study to evaluate the effects of self-medication with topical agents used by patients for superficial fungal skin infection at tertiary care hospital in Mumbai

Observational cross-sectional study to evaluate the effects of self-medication with topical agents used by patients for superficial fungal skin infection at tertiary care hospital in Mumbai

Topical steroids in dentistry: Adverse effects and proposal for application

Bedenken gegenüber topischen Kortikosteroiden: Zuwendung und Patientenaufklärung sind für Therapietreue essenziell

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