A study on the clinical profile of dermatoses induced by topical corticosteroids

Abstract

Background: Topical corticosteroids (TC), commonly used for a wide range of skin disorders, are associated with many side effects with their overuse, abuse and over-the-counter use as a cosmetic. This article aims to study clinical presentation of various dermatoses induced by abuse of TC in order to bring awareness among patients and practitioners to use topical corticosteroids with utmost caution.

Methods: This study was conducted at DVL department of a tertiary care teaching hospital over 23 consecutive months. A total of 200 consecutive patients of all ages and both genders with topical steroid induced dermatoses were included in the study. A detailed clinical evaluation was undertaken, data was then recorded and analysed.

Results: Majority of the patients were females (56%). Most common age group was 20-29 years (42%). Majority used TC as a remedy for dermatophytosis (38%), followed by use as a fairness/cosmetic cream (20%). Most of patients (29.5%) used TC for 6 months duration. Most commonly used TC formulation was 0.05% clobetasol propionate (37.5%). Majority patients (62%) did not have a valid prescription of which 47% used TC on Quacks’s advice. The most common side effects encountered were tinea incognito (33%), steroid-induced acne (20.5%), hyperpigmentation (14.5%), and hypopigmentation in 22 (11%).

Conclusions: Present study highlights irrational prescription of TC by non-dermatologists for dermatophytosis which are very common in this particular study region and emphasizes the need to educate patients about serious adverse effects of TC abuse.