Successful Treatment of Corticosteroid-Induced Rosacea-Like Dermatitis with Platelet-Rich Plasma Mesotherapy: Report of Seven Cases

Abstract

Introduction Corticosteroid-induced rosacea-like dermatitis (CIRD) is one of the cutaneous side effects of long and excessive application of topical corticosteroids, resembling rosacea that can present with a series of cutaneous manifestations. Most patients with CIRD undergo a variety of long-term treatments before their symptoms are relieved as there is no accepted standard therapy. We gave each of seven patients two sessions of platelet-rich plasma (PRP) mesotherapy before the routine treatment to restore their skin barrier function, and we were surprised to find that the patients’ symptoms and appearance were significantly improved without any further treatments. Here we report this unexpected finding in dealing with CIRD. Case Presentation Seven patients, one male and six female, who had history of applying topical corticosteroids on the face for more than 3 months continuously or intermittently for various reasons were diagnosed with CIRD, showing varying degrees of erythema, telangiectasia, and papules, with dry skin, pain, and burning or stinging sensation. We intended to use the restorative effect of PRP to restore the skin barrier function of the patients for further treatment such as tacrolimus ointment, intense pulsed light (IPL), or pulsed dye laser (PDL), so they were treated twice with PRP intradermal injections using a mesogun injector machine. We used the VISIA skin detector to photograph and compare the changes after the treatments. Clinical efficacy was also assessed by the Global Aesthetic Improvement Scale (GAIS). Patients’ assessments were recorded using three-point scale questionnaires. After two sessions of PRP treatment, before any further treatment, we were surprised to find that the patients' symptoms had improved significantly, as confirmed by VISIA skin detector and GAIS. All of the patients were satisfied with the outcomes, considering that mesotherapy was not painful and their appearance and symptoms had much improved. Conclusions PRP mesotherapy may mitigate sensitivity and inflammation in patients with CIRD by reducing erythema, telangiectasia, and papules. It is worth conducting large randomized controlled trials to verify its safety and efficacy in treating corticosteroid-induced rosacea-like dermatitis and maybe rosacea.

Platelet rich plasma in treatment of topical steroid damaged face: A retrospective analytical study

“…Day-60 in one study. 1 One study also demonstrated that after a single PRP injection on the cheeks, majority of the patients were significantly satisfied on FACE-Q post care scales whereas according to GIAS score, 14 (45.1%) patients had esthetic improvement. 18 Histopathological analysis has also demonstrated increase in collagen density within the dermis and subcutaneous layer after PRP treatment.…”

“…PRP has been successfully used in the treatment of corticosteroid‐induced rosacea like dermatitis with about 71.4% patients reporting improvement at Day‐30 and in 100% patients at Day‐60 in one study 1 . One study also demonstrated that after a single PRP injection on the cheeks, majority of the patients were significantly satisfied on FACE‐Q post care scales whereas according to GIAS score, 14 (45.1%) patients had esthetic improvement 18 .…”

“…Patients with TSDF generally have skin atrophy, telangiectasia, dryness, and burning or stinging sensation, indicating impaired skin barrier function, so restoration of the skin barrier function plays an important role in treatment 1 …”

“…Topical steroid damaged/dependent face (TSDF) is a cutaneous disorder that arises secondary to unsupervised, excessive, or prolonged use of topical corticosteroids (TC) on the face 1,2 . Skin involvement presents with varying constellation of signs and symptoms such as skin atrophy, persistent or recurrent erythema, telangiectasia, acneiform eruption, pustules, pruritus, dryness, and burning or stinging sensation 3 .…”

Comparison of the Efficacy of Two Different Local Anesthesia Techniques for Mesotherapy in Temporal Region Alopecia

“…Compared to conventional oral drugs, it has fewer systemic side effects and can administer pharmaceuticals directly to damaged tissues, improving efficacy. Furthermore, mesotherapy has shown promise in the management of alopecia and cellulite, among other dermatological issues [ 6 ].…”