Steroid - induced rosacea: A clinical study of 200 patients

Abstract

Background:Topical corticosteroids were first introduced for use in 1951. Since then uncontrolled use (abuse) has caused many different reactions resembling rosacea – steroid dermatitis or iatrosacea. Multiple pathways including rebound vasodilatation and proinflammatory cytokine release have been proposed as the mechanism for such reactions.Aim:The aim was to study the adverse effects of topical steroid abuse and the response to various treatment modalities.Materials and Methods:Two hundred patients with a history of topical steroid use on face for more than 1 month were studied clinically and various treatments tried.Results:The duration of topical corticosteroid use varied from 1 month to 20 years with an average of 19.76 months. Majority of patients were using potent (class II) topical steroids for trivial facial dermatoses. The common adverse effects were erythema, telangiectasia, xerosis, hyperpigmentation, photosensitivity, and rebound phenomenon. No significant change in laboratory investigations was seen.Conclusion:A combination of oral antibiotics and topical tacrolimus is the treatment of choice for steroid-induced rosacea.

Topical corticosteroid abuse on face: a clinical study of 100 patients

“…In our study, acne aggravation and acneiform eruption due to TCs was seen in 35% patients. 8,12 This is almost similar to the result of study by Bhat YJ et al reporting 35% patients with acneiform eruption. 10 Brar KB et al observed acneiform eruption in 56% cases as the most common side effect.…”

Topical Corticosteroids - A Great Challenge to Avoid Misuse on Face

“…[15] Persistent use of TCS can also lead to complications such as epidermal atrophy, degeneration of dermal structure with decrease collagen synthesis, rosacea, and susceptibility to superficial bacterial, viral and fungal infections. [14] Almost all these adverse effects were observed in our patients.…”

“…[15] Various other terms have been used by authors describing this entity such as topical steroid dependent face (TSDF), red face syndrome, steroid dermatitis resembling rosacea (SDRR) and steroid rosacea. [14] TSDF is a new entity characterized by erythema or burning sensation or pruritus on attempted cessation of TCS application. [15] Persistent use of TCS can also lead to complications such as epidermal atrophy, degeneration of dermal structure with decrease collagen synthesis, rosacea, and susceptibility to superficial bacterial, viral and fungal infections.…”

“…[9] Discontinuation of TCS after prolonged use results in severe rebound erythema, burning sensation and scaling on the face. [14] TCS induced rosacea like dermatitis (TCIRD) is defined as a condition arising from prolonged use and the rebound phenomenon, which appears after discontinuation of TCS on the face. [15] Various other terms have been used by authors describing this entity such as topical steroid dependent face (TSDF), red face syndrome, steroid dermatitis resembling rosacea (SDRR) and steroid rosacea.…”

Topical steroids - fairness fervour to fallout

“…Similar findings with some variations were observed in other studies. [14][15][16] It has been suggested that multiple pathways including rebound vasodilatation and pro-inflammatory cytokine release by chronic steroid use induce erythema and rosacea-like eruption. 17 Most of the patients in our study (68%) used potent to very potent TCs, which is in concordance with aforementioned studies from other studies.…”