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. 2017 Nov-Dec;62(6):675.
doi: 10.4103/ijd.IJD_110_17.

Topical Corticosteroids Abuse: A Clinical Study of Cutaneous Adverse Effects

Soniya Meena  1 , Lalit Kumar Gupta  2 , Ashok Kumar Khare  1 , Manisha Balai  1 , Asit Mittal  1 , Sharad Mehta  1 , Garima Bhatri  2
Affiliations

Topical Corticosteroids Abuse: A Clinical Study of Cutaneous Adverse Effects

Soniya Meena et al. Indian J Dermatol. 2017 Nov-Dec.

Abstract

Background: Topical corticosteroids (TC) are one of the most widely used agents in dermatology practice. Misuse of these agents may lead to a wide range of adverse effects.

Aim: This study was conducted to assess the magnitude of abuse of topical corticosteroids (TC) and clinical patterns of cutaneous adverse effects amongst patients attending dermatology department of a teaching hospital at South Rajasthan.

Materials and methods: All patients who reported with adverse effects of topical steroids during one year from September 2015 to August 2016 were evaluated. Patients fulfilling the study criteria were registered for further workup.

Results: Out of the 85280 new patients, 370 (0.43%) presented with adverse effects of TC. Males (232/370;62.70%) outnumbered females (138/370;37.30). Age group 11-30 years was most commonly (74.05%) affected. The main reason for using TC was fungal infection (52.43%). Tinea incognito (49.46%) and acne (30.27%) were the most common adverse effects recorded.

Conclusions: Abuse of TC, particularly the superpotent and potent is rampant amongst general population. Topical corticosteroids are frequently used for indications where they should be avoided.

Keywords: Corticosteroid abuse; tinea incognito; topical corticosteroids; topical steroid-dependent facies.

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Conflict of interest statement

There are no conflicts of interest. What is new? The TC abuse is not uncommon even in males and literate masses. The tendency to use TC in dermatophytic infection is rampant leading to modification in clinical picture and therefore posing difficulty in its successful treatment. Enhanced and concerted efforts on the part of patients, prescribers, and regulatory health agencies are needed to overcome the challenge of steroid abuse.

Figures

Figure 1
Figure 1
(a-c) Various topical corticosteroids abused by the patients
Figure 2
Figure 2
(a and b) Tinea pseudoimbricata. (c and d) Tinea incognito with striae rubra
Figure 3
Figure 3
(a) Monomorphic acne over face. (b) Monomorphic acne over chest. (c) Nodulocystic acne
Figure 4
Figure 4
(a and b) Rosacea
Figure 5
Figure 5
(a and b) Topical steroid-dependent facies
Figure 6
Figure 6
(a and b) Telangiectasia
Figure 7
Figure 7
(a and b) Perioral dermatitis
Figure 8
Figure 8
Cutaneous atrophy
Figure 9
Figure 9
(a and b) Hypopigmentation
Figure 10
Figure 10
Hypertrichosis
Figure 11
Figure 11
(a and b) Pyoderma with modified tinea
Figure 12
Figure 12
Irritant contact dermatitis
See this image and copyright information in PMC

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