Title : Dermoscopy of topical steroid damaged faces
Abstract:
Introduction: Unsupervised overuse of Topical Corticosteroids (TCS) is highly common in dermatological practice, leading to steroid abuse known as topical steroid damaged face. Topical corticosteroid abuse is rampant and results in steroid addiction labeled as Topical Steroid-Dependent or Damaged Face (TSDF). Indian market is replete with triple combination creams containing TCS sold as over-the counter products at low cost, luring people to use them without prescription. The resultant damage if detected late is irreversible and difficult to treat. Dermoscopy can help in the early identification of features of TSDF at a preclinical stage resulting in better prognosis.
Aims:
1.To study Morphological dermoscopic patterns in Topical steroid damaged faces
2. To correlate dermoscopic patterns with duration of application of topical corticosteroids.
Type of Study: Hospital based observational study
Materials & Methods: Dermoscopic examination was done after taking consent in 60 patients aged 15 years and above, with clinical symptoms and signs suggestive of TSDF and with history of application of TCS on the face for a period of more than two month, are enrolled in the study. Their demographic details, clinical features, and dermoscopy findings are recorded using a predesigned structured format. Comparison of dermoscopic findings with clinical examination, gender, potency of TCS, and duration of TCS use was done using Chi-square test.
Results: Mean age of the patients was 25 ± 6 years. Clinical findings noted in the patients were erythema (87%), hyperpigmentation (84.6%), and hypertrichosis (70%). The most common dermoscopy findings seen are brown globules (98.7%), red diffuse areas (94.4%), vessels (90%), white structureless areas (84%), and hypertrichosis (82.4%). Red diffuse areas, vessels, brown globules, white structureless areas, and white hair were observed in a statistically higher proportion of cases dermoscopically. Y-shaped vessels and brown globules were seen in significantly higher number of patients, using TCS for more than three months and in those continuing it beyond six months, polygonal vessels were predominant.
Conclusion: Dermoscopy in Topical steroid damagefaces can help dermatologists in a multitude of ways from confirming the diagnosis to differentiating from other causes of red face and predicting the approximate duration of TCS abuse.
