Topical Steroid Damaged/Dependent Face (TSDF): An Entity of Cutaneous Pharmacodependence

Abstract

Topical Steroid Damaged/Dependent face (TSDF) is a phenomenon which has been described very recently (2008). It is characterized by a plethora of symptoms caused by an usually unsupervised misuse/abuse/overuse of topical corticosteroid of any potency on the face over an unspecified and/or prolonged period of time. This misuse and damage have a serious effect on the quality of life of the patients in general and the skin of the face in particular. Management is difficult and necessitates psychological counseling as well as physical soothing of the sensitive skin.

Keywords: Face; TSDF; misuse; steroid dependence; topical steroid.

Figure 1

(a-e) Erythema due to topical steroid abuse

Figure 2

(a and b) Papules due to topical steroid abuse

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(a-c) Pustules (secondary bacterial infections) due to topical steroid abuse

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(a-c) Acneiform eruptions due to topical steroid abuse

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(a-d) Hirsutism due to topical steroid abuse

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(a and b) Telangiectasia due to topical steroid abuse

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(a-d) Tinea incognito due to topical steroid abuse

Figure 8

(a and b) Hypo- and hyper-pigmentation due to topical steroid abuse

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(a-c) Perioral dermatitis due to topical steroid abuse

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(a-c) Rosacea-like features due to topical steroid abuse

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(a and b) Allergic contact dermatitis due to topical steroid abuse

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(a and b) Photosensitivity due to topical steroid abuse

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(a and b) Atrophy and striae due to topical steroid abuse