Study of clinicodermoscopic features of topical steroid damaged face patients
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20232534Keywords:
Dermoscopy, Red face, TCS, Topical steroid-dependent damaged faceAbstract
Background: Topical steroid dependent or damaged face is an alarming upcoming entity rampant in India due to over-the-counter availability of topical corticosteroids containing products. The present study aimed to study the clinical and dermoscopic changes in patients with topical steroid damaged face and to correlate them with potency and duration of application of the TCS.
Methods: 80 patients visiting the dermatology OPD & IPD at SAIMS Hospital & PG Institute, Indore, with the chief complains of redness, itching, red raised lesions, burning, swelling, photosensitivity, pigmentation; with a history of application of topical corticosteroids of any potency on face for continuous 7 days or intermittent for 15 or more days were enrolled for the study.
Results: Mean age of the patients was 31.5±8.13 years. Male to female ratio was 1:9. Twelve (15.2%) patients abused TCS for more than one year. Presenting complains of the patients were redness (82.5%), itching (66.3%), hypertrichosis (47.5%), pigmentation (66.3%), burning (38.8%) and acne (28.8%). The most common dermoscopy findings i.e., unpatterned brown pigmentation (86.3%), polygonal vessels (73.8%), fine scales (52.5%), hypertrichosis (53.8%), follicular plugs (32.5%), micropustules (15%) and ivory patches (11.3%) were observed in a statistically higher proportion of cases dermoscopically
Conclusions: Dermoscopy in TSDF can help dermatologists in a multitude of ways from confirming the diagnosis to differentiating from other causes of red face and predicting the approximate duration of TCS abuse.
References
Lahiri K, Coondoo A. Topical steroid damaged/dependent face (TSDF): An entity of cutaneous pharmacodependence. Indian J Dermatol. 2016;61:265-72.
Kragballe K. Topical corticosteroids: Mechanisms of action. Acta Derm Venereol Suppl. 1989;151:7-10.
Jain S, Mohapatra L, Mohanty P, Jena S, Behera B. Study of clinical profile of patients presenting with topical steroid-induced facial dermatosis to a tertiary care hospital. Indian Dermatol J. 2020;11:208-11.
Coondoo A. Topical corticosteroid misuse: The Indian scenario. Indian J Dermatol. 2014;59:451-5.
Gabros S, Nessel TA, Zito PM. Topical Corticosteroids. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
Pal D, Biswas P, Das S, De A, Sharma N, Ansari A. Topical steroid damaged/dependent face (TSDF): A study from a tertiary care hospital in Eastern India. Indian J Dermatol. 2018;63:375 9.
Hameed AF. Steroid dermatitis resembling rosacea: A clinical evaluation of 75 patients. Dermatol. 2013; 2013:491376.
Tatu AL. Topical steroid induced facial rosaceiform dermatitis. Acta Endocrinol. 2016;12:232-3.
Saraswat A, Lahiri K, Chatterjee M, Barua S, Coondoo A, Mittal A, et al. Topical corticosteroid abuse on the face: A prospective, multicenter study of dermatology outpatients. Indian J Dermatol Venereol Leprol. 2011;77:160-6.
Kakkar S, Sharma PK. Topical steroid-dependent face: Response to xylometazoline topical. Indian J Drugs Dermatol. 2017;3:87-9.
Litt JZ. Steroid-induced rosacea. Am Fam Physician. 1993;48:67-71.
Saraswat A, Lahiri K, Chatterjee M, Barua S, Coondoo A, Mittal A, et al. Topical corticosteroid abuse on the face: A prospective, multicenter study of dermatology outpatients. Indian J Dermatol Venereol Leprol. 2011;77:160-6.
Sethi S, Chauhan P, Jindal R, Bisht YS. Dermoscopy of topical steroid-dependent or damaged face: A cross-sectional study. Indian J Dermatol Venereol Leprol. 2022;88:40-6.
Inakanti Y, Thimmasarthi VN, Anupama, Kumar S, Nagaraj A, Peddireddy S, et al. Topical corticosteroids: Abuse and Misuse. Dermatol. 2015;6: 130-4.
Dey VK. Misuse of topical corticosteroids: A clinical study of adverse effects. Indian Dermatol J. 2014;5: 436-40.
Pal D, Biswas P, Das S, De A, Sharma N, Ansari A. Topical Steroid Damaged/Dependent Face (TSDF): A Study from a Tertiary Care Hospital in Eastern India. Indian J Dermatol. 2018;63(5):375-9.
Al Dhafiri M, Alali AB, Alghanem ZA, Alsaleh ZW, Boushel EA, Alali ZB, et al. Topical Steroid Damaged Face: A Cross-Sectional Study from Saudi Arabia. Clin Pract. 2022;12(1):140-6.
Nyati A, Singhal AK, Yadav D, Sharma MK. Topical steroid abuse on face: A prospective study from a tertiary care centre of north India. Int J Res Dermatol. 2017;3(3):433-41.
Kar S, Gupta B, Barbhuiya GK. Self administration of topical steroids in face: A cross-sectional study from a tertiary care hospital in Northeast India. IP Indian J Clin Exp Dermatol. 2022;8(2):118-23.
Mahar S, Mahajan K, Agarwal S, Kar HK, Bhattacharya SK. Topical corticosteroid misuse: the scenario in patients attending a tertiary care hospital in New Delhi. J Clin Diagn Res. 2016;10(12):FC16-20.
Lu H, Xiao T, Lu B, Dong D, Yu D, Wei H, et al. Facial corticosteroid addictive dermatitis in Guiyang City, China. Clin Exp Dermatol. 2010;35:618-21.
Sonthalia S, Jha AK, Sharma R. The role of dermoscopy in a topical steroid-damaged face. Dermatol Pract Concept. 2018;8:166-7.
Jakhar D, Kaur I. Dermoscopy of topical steroid damaged/dependent face. Indian Dermatol J. 2018;9: 286-7
Abdallah MA, Zuelfakkar NM, Elbana RH. Comparative study of male and female sebum production. Egypt J Hosp Med. 2017;69:1847-79.