Appropriateness of Topical Corticosteroids Usage in Dermatology Patients of a Tertiary Care Hospital

Background: Topical Corticosteroids (TCs) have been a cornerstone in the management of various dermatological conditions. The dual nature of their widespread use and potential for misuse has emerged as a significant concern, particularly in resource-limited settings such as tertiary care government teaching hospitals. The aim of the study is to analyse the prescription patterns and appropriateness of TCs usage among the dermatology patients. Materials and Methods: A prospective observational study was carried out in the out-patient dermatology department of a tertiary care government teaching hospital. Adult patients (18-60 years) who consulted the dermatology department and prescribed TCs were included in the study. Patient’s sociodemographic details, dosage form, strength, frequency and duration of TCs were documented. Depending on the strength of TCs, the potency of TCs were classified and their appropriateness was evaluated by validated questionnaire. Results: This study evaluated 160 dermatology patients prescribed TCs in a tertiary care hospital. Male patients (58.12%) predominated, with seborrheic dermatitis (55.62%) being the most common condition followed by eczema, lichen planus, lichen simplex chronicus. Potent TCs (33.75%) were frequently prescribed. Appropriateness scores averaged 68.4%, indicating suboptimal adherence to guidelines, particularly in allergic contact dermatitis (35%). Addressing improper usage through clinical education and standardized protocols is essential. Conclusion: This study highlights inappropriate topical corticosteroid use and suboptimal guideline adherence (68.4%) by the patients. Potent steroids were often prescribed, especially for seborrheic dermatitis. Improved prescribing practices, pharmacist involvement in dispensing, patient education and counselling are essential to ensure safe, effective, and rational use of TCs.