Topical corticosteroid induced ulcerated striae

Verma, Shyam; Madke, Bhushan

doi:10.1016/j.abd.2020.07.003

Cited by 7 publications

(5 citation statements)

References 7 publications

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“…Frequently seen consequences of misuse of potent topical steroids include striae rubra, striae albae, hypopigmentation, telangiectasias, thinning of the skin, and extensive tinea [ 57 ]. Striae can also ulcerate or appear edematous [ 58 , 59 ].…”

Section: Abuse Of Topical Glucocorticoids and The Emergence Of ...mentioning

confidence: 99%

Trichophyton indotineae—An Emerging Pathogen Causing Recalcitrant Dermatophytoses in India and Worldwide—A Multidimensional Perspective

Uhrlaß¹,

Verma²,

Gräser

et al. 2022

JoF

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Trichophyton (T.) indotineae is a newly identified dermatophyte species that has been found in a near-epidemic form on the Indian subcontinent. There is evidence of its spread from the Indian subcontinent to a number of countries worldwide. The fungus is identical to genotype VIII within the T. mentagrophytes/T. interdigitale species complex, which was described in 2019 by sequencing the Internal Transcribed Spacer (ITS) region of ribosomal DNA of the dermatophyte. More than 10 ITS genotypes of T. interdigitale and T. mentagrophytes can now be identified. T. indotineae causes inflammatory and itchy, often widespread, dermatophytosis affecting the groins, gluteal region, trunk, and face. Patients of all ages and genders are affected. The new species has largely displaced other previously prevalent dermatophytes on the Indian subcontinent. T. indotineae has become a problematic dermatophyte due to its predominantly in vitro genetic resistance to terbinafine owing to point mutations of the squalene epoxidase gene. It also displays in vivo resistance to terbinafine. The most efficacious drug currently available for this terbinafine-resistant dermatophytoses, based on sound evidence, is itraconazole.

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Section: Abuse Of Topical Glucocorticoids and The Emergence Of ...mentioning

confidence: 99%

Trichophyton indotineae—An Emerging Pathogen Causing Recalcitrant Dermatophytoses in India and Worldwide—A Multidimensional Perspective

Uhrlaß¹,

Verma²,

Gräser

et al. 2022

JoF

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“…To the best of our knowledge, there has only been a single case report of Fournier's gangrene secondary to prolonged topical steroid application wherein topical steroid was employed as a bleaching agent (Table 2) [18]. There are some case reports of skin ulceration secondary to steroid application as a result of epidermal atrophy and impaired wound healing, yet tissue cultures were negative [19]. Thus, prolonged use of steroid creams leads to ulceration and increases the susceptibility to infections.…”

Section: Discussionmentioning

confidence: 99%

Topical steroid menace: A case series of severe debilitating infections during the COVID-19 pandemic

Patil¹,

Shivaswam²,

Reddy³

et al. 2023

Our Dermatol Online

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Background: Topical corticosteroids is a boon and also a bane in treating chronic skin conditions. The risk of cutaneous infections due to topical steroids increases with their potency, dose, and duration of treatment. Herein, we present a case series of severe debilitating infections secondary to topical steroid abuse. Materials and Methods: We came across five cases of severe skin infection following the prolonged application of topical steroids. These cases gave a history of the use of steroid creams for persistent skin conditions and the inability to visit the hospital due to the prevailing COVID-19 pandemic. Observations: We came across two cases of crusted scabies, two cases of Fournier’s gangrene, and a case of erosio interdigitalis blastomycetica. These cases had been using topical steroids for a prolonged period for other dermatological conditions. Conclusion: We propose that, as crusted scabies and erosio interdigitalis blastomycetica mimic various other papulosquamous disorders, a KOH examination is a diagnostic tool. Topical steroid abuse is one of the predisposing factors for Fournier’s gangrene. Key words: Topical Steroids; Crusted Scabies; Fournier’s Gangrene; COVID-19

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“…Study concluded 20% azelaic acid applied two times every day may be superior to HQ 4% in decreasing mild Melasma [28]. Few of the related studies were reviewed [29][30][31][32][33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Combination of Oral Tranexamic Acid with Modified Kligman’s Formula Versus Oral Tranexamic Acid with Azelaic Acid 15% in the Treatment of Melasma

Singh

Maheshwari

2021

JPRI

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Background: Melasma refers to acquired hyper-pigmentary condition effecting skin. Owing to its multifactorial causation and chronicity, there is an increased need for new multimodality therapies to treat melasma more effectively and to prevent the side effects seen with the conventional modalities of treatment. Objectives: Compare efficacy of combining oral Tranexamic Acid and Azelaic Acid 15% with that of Oral Tranexamic Acid (TA) and Modified Kligman’s Formula. Also, to record any adverse effects of combining these agents. Methods: Patients having Melasma who will be coming to Dermatology OPD, AVBRH, Sawangi, Wardha, will be enrolled after considering the various inclusion and exclusion criteria. A detailed history will be asked, which will be followed by a cutaneous examination that includes the calculation of MASI (Melasma Area and Severity Index). One Group (A) - participants will receive - Oral 500 mg Tranexamic acid OD plus Modified Kligman’s Formula (fluocinolone acetonide 0.01%, tretinoin 0.05%, and hydroquinone 2%) cream one time at night only. Second Group (B)- participants will receive - Oral 500 mg Tranexamic Acid OD plus Azelaic Acid 15% gel once daily at night only. Both groups will also receive Broad-spectrum sunscreen SPF-30 daily (3 hourly). Patients will be called for regular follow up at 4 weeks and 8 weeks (for early results). Clinical photos will be clicked at every follow-up visit and MASI score shall be doocumented. Expected Results: To analyze efficacy of combining Oral TA along with Azelaic Acid 15% and if it provides better results, we can avoid the undesirable side effects that are seen on prescribing the Modified Klingman’s Formula, in Melasma patients. Conclusion: This study will help us in analyzing efficacy of combining Oral TA with Azelaic Acid 15%, therefore will provide a newer treatment modality with lesser side effects and maybe better results than the gold standard- Modified Klingman’s Formula.

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Topical corticosteroid induced ulcerated striae

Abstract: We report four cases of ulcerated striae following misuse of fixed dose combinations creams containing clobetasol propionate with antifungal and antibacterial agents.

Cited by 7 publications

References 7 publications

Trichophyton indotineae—An Emerging Pathogen Causing Recalcitrant Dermatophytoses in India and Worldwide—A Multidimensional Perspective

Trichophyton indotineae—An Emerging Pathogen Causing Recalcitrant Dermatophytoses in India and Worldwide—A Multidimensional Perspective

Topical steroid menace: A case series of severe debilitating infections during the COVID-19 pandemic

Comparative Study of Combination of Oral Tranexamic Acid with Modified Kligman’s Formula Versus Oral Tranexamic Acid with Azelaic Acid 15% in the Treatment of Melasma

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