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

Abstract

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