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Atopic Eczema — SCE Dermatology MCQ

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EasyInflammatory DermatosesAtopic EczemaSCE Dermatology

A 30-year-old woman with widespread eczema has been using topical corticosteroids for years. She expresses fear of all topical steroids due to reading about side effects online ('steroid phobia'). This leads to under-treatment and poor disease control. How should this be addressed?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Provide balanced education about risks vs benefits, demonstrate correct application technique and amounts (FTU), and address specific concerns empathetically

Topical corticosteroid phobia ('steroid phobia') is a well-recognised barrier to eczema treatment adherence, affecting up to 70-80% of eczema patients/carers. BAD and NICE emphasise patient education as a cornerstone of eczema management: explaining the safety of appropriate topical steroid use, demonstrating correct application technique and fingertip units (FTU), distinguishing between potency classes, explaining where each potency is appropriate, and addressing specific concerns (e.g., skin thinning is rare with appropriate use and usually reversible). Written eczema action plans and structured education programmes (nurse-led eczema workshops) improve concordance and outcomes. Validating concerns while providing evidence-based reassurance is key.

Reference: NICE CG57; BAD AD Guidelines