Quality of life in patients with facial steroid dermatitis before and after treatment

Abstract

Background: Improper long-term, even low-dose, topical corticosteroids, especially application to the face, could induce steroid dermatitis, which was refractory and detrimental to the quality of life.

Objective: To evaluate the quality of life in patients with facial steroid dermatitis before and after the treatment of doxycycline and indomethacin plus support therapy.

Study design: A prospective study.

Setting: Outpatients of the Department of dermatology, the Third Hospital of Hangzhou, from August 2, 2004, to April 20, 2005.

Subjects: Fifty consecutive outpatients completed the treatment.

Intervention: The intervention is doxycycline 10 mg twice a day and indomethacin 25 mg twice a day for 4 weeks, cetirizine or loratadine 10 mg daily if pruritic, topical white petroleum if feeling dry and wet dressing if burning and oedema, plus psychological support and health education.

Main outcome measure: The efficacy of the treatment was quantified using a 24-point steroid clinical score. The detriment of the quality of life was quantified using a 30-point Dermatology Life Quality Index.

Results: The steroid dermatitis clinical score decreased significantly from 15.06 +/- 4.61 at baseline to 4.52 +/- 3.39 at 2 weeks after the end of treatment (week 6; P < 0.001). Twenty-one patients underwent a rebound phenomenon and the steroid dermatitis clinical score increased significantly from 13.71 +/- 4.33 at baseline (week 0) to 19.24 +/- 3.40 at 1 week after treatment (week 1; P < 0.001). Quality of life score decreased significantly from 13.76 +/- 7.68 at baseline to 3.44 +/- 2.57 at 2 weeks after the end of treatment (week 6; P < 0.001).

Conclusions: The quality of life was profoundly affected by facial steroid dermatitis. Doxycycline and indomethacin plus support therapy might be effective in patients with facial steroid dermatitis.