Dermatology Department, University Hospital of Nancy, Batiment P Canton, 6 allée du Morvan, 54500, Vandoeuvre les Nancy, France.
Dermatology Department, Hospital Victor Dupouy, Argenteuil, France.
Am J Clin Dermatol. 2018 Apr;19(2):261-265. doi: 10.1007/s40257-017-0318-5.
Atopic dermatitis (AD) and psoriasis are chronic inflammatory cutaneous disorders for which the gold standard treatment is topical corticosteroids. Although fears about topical corticosteroids are known to be a primary cause of poor therapeutic adherence in AD, this has not been evaluated in psoriasis. TOPICOP is a helpful and easy-to-use tool for the evaluation of topical corticosteroid concerns (TCC). It may help clinicians improve adherence to treatment and correct misconceptions.
We aimed to compare the TCC of parents of children with psoriasis or AD using the TOPICOP scale and a visual analog scale (VAS).
We performed a cross-sectional multicenter study in nine French hospitals from 1 October 2015 to 31 May 2016. The TOPICOP scale was developed for patients with AD and comprises 12 questions to assess patients' worries and beliefs about topical corticosteroids, with a maximum score of 36. We used a standardized questionnaire to collect epidemiologic and medical data, and the parents completed the TOPICOP scale and VAS (score 0-10).
A total of 122 children were enrolled (61 patients in each group). The mean Physician Global Assessment was 2.1 in the psoriasis group, and the mean SCORing AD index was 33.3 in the AD group. The TOPICOP score was 16.0 in the psoriasis group and 18.8 in the AD group (p = 0.10). The VAS score was 5.6 and 5.1 in the psoriasis and AD groups, respectively (p = 0.18). The mean TOPICOP score was higher if the mother answered (p < 0.0001; odds ratio 12.3; 95% confidence interval 9.2-15.5). In the AD group, the mean TOPICOP score was higher if follow-up for the child was as an outpatient (p = 0.018). In the psoriasis group, the mean TOPICOP score was higher if patients were seen for the first time (p = 0.047).
Using the TOPICOP questionnaire and a VAS, we found the level of TCC for the parents of pediatric patients with psoriasis to be similar to that for parents of pediatric patients with AD. As TCC is an issue in patients with psoriasis, future research is warranted to assess whether therapeutic education lessens TCC and improves treatment outcomes.
特应性皮炎（AD）和银屑病是两种慢性炎症性皮肤疾病，其金标准治疗方法为局部皮质类固醇。尽管人们已知对局部皮质类固醇的担忧是导致 AD 治疗依从性差的主要原因，但这在银屑病中尚未得到评估。TOPICOP 是一种评估局部皮质类固醇担忧（TCC）的有用且易于使用的工具。它可能有助于临床医生提高治疗依从性并纠正误解。
我们旨在使用 TOPICOP 量表和视觉模拟量表（VAS）比较患有银屑病或 AD 的儿童的父母的 TCC。
我们于 2015 年 10 月 1 日至 2016 年 5 月 31 日在法国的九家医院进行了一项横断面多中心研究。TOPICOP 量表专为 AD 患者开发，包含 12 个问题，用于评估患者对局部皮质类固醇的担忧和信念，最高得分为 36 分。我们使用标准化问卷收集流行病学和医学数据，父母完成 TOPICOP 量表和 VAS（得分 0-10）。
共纳入 122 名儿童（每组 61 名患者）。银屑病组的平均医生整体评估得分为 2.1，AD 组的 SCORing AD 指数平均得分为 33.3。银屑病组的 TOPICOP 评分为 16.0，AD 组的评分为 18.8（p=0.10）。银屑病组和 AD 组的 VAS 评分分别为 5.6 和 5.1（p=0.18）。如果母亲回答问题，则平均 TOPICOP 评分更高（p<0.0001；优势比 12.3；95%置信区间 9.2-15.5）。在 AD 组中，如果患儿为门诊就诊（p=0.018），则平均 TOPICOP 评分更高。在银屑病组中，如果患者首次就诊（p=0.047），则平均 TOPICOP 评分更高。
使用 TOPICOP 问卷和 VAS，我们发现父母对患有儿童银屑病的患儿的 TCC 水平与父母对患有儿童 AD 的患儿的 TCC 水平相似。由于 TCC 是银屑病患者的一个问题，因此有必要进行进一步的研究来评估治疗教育是否可以减轻 TCC 并改善治疗结果。
