Patients With Severe Dermatitis Express Phobia of Topical Corticosteroids

woman with atopic dermatitis
woman with symptom of atopic dermatitis on brow and brows
Trends in the prevalence of atopic dermatitis in a university population are explored, as is the relationship between disease severity and hospital visits and diagnoses.

A survey of patients with atopic dermatitis (AD) found that medical professionals likely need to promote more effective communication and education about topical corticosteroids (TCS), according to results of a study published as a concise communication article in The Journal of Dermatology.

As the longitudinal trend in the prevalence of AD among adults is poorly understood, freshmen (N=38,086) attending Hiroshima University in Japan were evaluated for AD from 2002 to 2019. Dermatologists diagnosed and graded the severity of AD and participants responded to a survey about AD opinions.

The students were aged mean 18.6±2.7 years. Among all students, the instance of asthma and allergic rhinitis or conjunctivitis comorbidities was increasing over time.

In 2002, the prevalence of AD was 9.1%, increasing to 12.0% in 2010 and remaining stable at 10% to 11% until 2019. The percentage of students with mild AD gradually declined while the prevalence of moderate AD was increasing. Severe AD was maintained at less than 10% throughout the study period.

Among the students with severe AD, facial eczema was common; it occurred in approximately 50% of those with moderate AD and in approximately 20% among those with mild AD.

Students reported seeking medical care (26.5%-36.0%) and using self-care (26.7%-38.0%) for their AD at similar rates. However, seeking medical care was related to severity. More students who sought medical care used TCS (67.9%-83.6%) than those who did not (1.2%-6.3%). However, 13.5% to 30.9% who were receiving medical care for their AD were unsure whether they were using TCS.

Phobia of TCS was reported by 11.1% to 11.5% of students with mild to severe AD, and was more frequent (35.0%) among students with the most severe AD.

This study could be limited by the study population, as these findings may not be generalizable to populations outside of the university system in Japan.

These data indicated to the researchers that the prevalence of AD among young adults remained about 10% in Japan from to 2019. The study authors concluded, “The current study results suggest the presence of substantial anxiety regarding TCS use among patients with AD and the necessity of promoting more effective explanation and education on AD by medical professionals in Japan.”


Kan T, Tanaka A, Kanamoto M, Morioke S, Takahagi S, Hide M. Longitudinal prevalence of atopic dermatitis among freshmen at Hiroshima University between 2002 and 2019.J Dermatol. Published online March 22, 2022. doi:10.1111/1346-8138.16366