Acroatrophy secondary to long-standing applications of topical steroids

Corticosteroid iatrogenesis in a patient with palmoplantar psoriasis

“…This case demonstrates that it is essential to exercise careful monitoring of the amount and duration of topical corticosteroids applied, and guidelines must be established for each patient. The overenthusiastic use of high‐potency topical corticosteroids can lead to dramatic consequences such as those seen in the present case 6,7 . Furthermore, lack of communication between general practitioners and specialists can lead to irreversible side‐effects, like those experienced by our patient.…”

Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy

“…Furthermore, a number of studies have documented a possible tapering of the treated digit, which is caused by atrophy of the underlying phalanx and is commonly known as ''disappearing digit.'' [57][58][59] Aside from these problems, other adverse effects include striae formation, development of telangectasias, tachyphylaxis, and potential systemic absorption of the steroid. With respect to the above studies, the only adverse reaction attributed to steroid application was seen in the investigation by Tosti et al, 55 in which there were 3 cases of erythema.…”

“…99,100 The chronic nature of the disease often requires repeated courses of the steroid, which can lead to reversible atrophy at the injection site 98,99 and potential atrophy of the underlying terminal phalanx, a condition known as ''disappearing digit.'' [57][58][59] Other complications, such as collagen atrophy and rupture of the extensor tendon, are only theoretical possibilities, because there are no well-documented cases of these events. 54 With respect to the needleless injectors, one study reported a puncture of the nail plate.…”

Nail psoriasis: The journey so far

“…[1] Furthermore, with persistent use of very potent topical steroids over years, a number of studies have documented a possible tapering of the treated digit, which can be caused by atrophy of the underlying phalanx and is commonly known as “disappearing digit”. [636465]…”