Topical Steroid Abuse in Children: A Glimpse from Bangladesh

Abstract

Introduction: Irrational use of topical steroids in the pediatric age group is common in Bangladesh. Before consulting with a dermatologist for skin disease, parents tend to use medicine from a previous prescription, consult a quack or take medicine from the pharmacy shopkeeper. As there is no regulation on dispensing steroids over the counter, it is really hard to control steroid abuse.

Aim: The study aimed to observe how steroid abuse occurred, which steroids were abused more and common side effects due to abuse.

Material and method: This was a cross-sectional study conducted at the outpatient department of different government and non-government hospitals in Dhaka, Bangladesh over 3 months. A total of 150 steroid-abused children were enrolled.

Results: The most affected age group was 2 to 6 years. About 96% of the abuse occurred due to recommendation by non-dermatologists, 58% of which was by Quacks and pharmacy salesman, 19% by general practitioners and 17% by paediatricians. The most common topical steroid used by patients was potent e.g. betamethasone dipropionate (46%). Out of 150 patients, 103 (68.6%) used pure steroid cream while 47 (31.4%) used steroid cream in combination with either antifungal or antibacterial or both. The most common side effect observed was tinea incognito, impetigo, and eczema herpeticum.

Conclusion: Topical steroid abuse in children is very common in our country. The problem is worsening due to the easy availability of these medications even without a proper prescription. Every physician should have a good knowledge of steroids before prescribing them. Education of the general public through different communication media should be taken to reduce this abuse.

Keywords: Topical Steroids, Abuse, Children, Bangladesh