Background: Non-adherence is a major hindrance to treatment success in any disease. In chronic diseases, adherence to long term treatment is about 50% but existing data on adherence to topical treatment in dermatological diseases are limited. In atopic eczema (AE), adherence to topical therapy is essential to control inflammation and maintain adequate moisturization but these treatment aims will not be achieved without optimal adherence. Objectives: To assess the frequency of treatment adherence among our patients with AE and to identify the influencing factors. Methods: We carried out a questionnaire-based study involving dermatology outpatients with AE. Demographic data were collected and patients or carers were interviewed to assess steroid phobia, knowledge, perception on treatment and use of alternative treatment. Results: Out of 75 patients included in the study, only 14.7% were adherent to treatment. 58.7% of patients had steroid phobia but this did not significantly affect adherence. 41% of patients who use alternative treatment had poor adherence compared to patients who did not. Conclusion: Adherence to topical treatment is poor among our AE patients and multi-pronged intervention is needed to improve adherence. For clinicians, non-adherence should be considered when managing patients who appear ‘resistant’ to optimized treatment.

Introduction: This study aims to investigate whether patients undergoing two-stage revision total hip arthroplasty (THA) for prosthetic joint infection (PJI) and one-stage revision THA for aseptic reasons have similar clinical outcomes and patient satisfaction during their post-operative follow-up. We hypothesise that the two-stage revision THA for PJI is associated with poorer outcomes as compared to aseptic revision THA. Materials and Methods: We reviewed prospectively collected data in our tertiary hospital arthroplasty registry and identified patients who underwent revision THA between 2001 and 2014, with a minimum of two years follow-up. The study group (two-stage revision THA for PJI) consists of 23 patients and the control group (one-stage revision THA for aseptic reasons) consists of 231 patients. Patient demographics, Western Ontario and McMaster Universities Arthritis Index (WOMAC), Oxford Hip Score (OHS), Short Form-36 (SF-36) scores and patient reported satisfaction were evaluated. Student’s t-test was used to compare continuous variables between the two groups. Statistical significance was defined as p <0.05. Results: The pre-operative demographics and clinical scores were relatively similar between the two groups of patients. At two years, patients who underwent revision THA for PJI reported a better WOMAC Pain Score and OHS as compared to aseptic revision THA. A similar proportion of patients were satisfied with their results of surgery in both groups (p=0.093). Conclusions: Although patients who underwent revision THA for PJI had poorer pre-operative functional scores (WOMAC function and SF-36 PF), at two years follow-up, these two groups of patients have comparable post-operative outcomes. Interestingly, patients who had revision THA for PJI reported a better clinical outcome in terms of OHS and WOMAC Pain score as compared to the aseptic group. We conclude that the revision THA for PJI is not inferior to aseptic revision THA in terms of patient satisfaction and clinical outcomes.