DERMOSCOPIC FINDINGS SECONDARY TO TOPICAL STEROID APPLICATION OVER FACE: A CROSS SECTIONAL STUDY
Main Article Content
Keywords
TSDF, topical corticosteroids, dermoscopy
Abstract
Introduction: Topical steroid-dependent or damaged face (TSDF) is the term used to describe the widespread overuse of topical corticosteroids (TCS), which leads to steroid addiction. The Indian market is flooded with triple combination creams that contain TCS and are inexpensively offered as over-the-counter goods, tempting consumers to use them without a prescription. If the damage is discovered too late, it is difficult to repair and permanent. A better prognosis can be obtained by using dermoscopy as a tool for early detection of preclinical characteristics of topical steroids.
Materials & Methods: An observational study was carried out on 110 patients who were over the age of 18 years and had been applying TCS to their faces for more than a month, along with clinical symptoms and signs suggestive of TSDF. A pre-planned, organized approach was used to record their clinical characteristics, demographic information, and dermoscopy results. The one-tailed Z-test, Fisher's exact test, and Chi-square test were used to compare the dermoscopic findings with the clinical examination, gender, TCS potency, and duration of use.
Results: Mean age of the patients was 37.7 years. Forty (36.4%) patients abused TCS for 6-12 months of duration. Clinical findings noted in the patients were hyperpigmentation (94.5%), telangiectasia (82.7%) and erythema (81.8%). The most common dermoscopy findings seen were brown globules (97.3%), red diffuse areas (91.8%), vessels (86.4%), hypertrichosis (76.4%) and desquamation (42.7%). Linear and serpentine vessels were seen in significantly higher number of patients.
Conclusion: Dermoscopy in TSDF 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.
Materials & Methods: An observational study was carried out on 110 patients who were over the age of 18 years and had been applying TCS to their faces for more than a month, along with clinical symptoms and signs suggestive of TSDF. A pre-planned, organized approach was used to record their clinical characteristics, demographic information, and dermoscopy results. The one-tailed Z-test, Fisher's exact test, and Chi-square test were used to compare the dermoscopic findings with the clinical examination, gender, TCS potency, and duration of use.
Results: Mean age of the patients was 37.7 years. Forty (36.4%) patients abused TCS for 6-12 months of duration. Clinical findings noted in the patients were hyperpigmentation (94.5%), telangiectasia (82.7%) and erythema (81.8%). The most common dermoscopy findings seen were brown globules (97.3%), red diffuse areas (91.8%), vessels (86.4%), hypertrichosis (76.4%) and desquamation (42.7%). Linear and serpentine vessels were seen in significantly higher number of patients.
Conclusion: Dermoscopy in TSDF 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.
References
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10. Jain S, Mohapatra L, Mohanty P, Jena S, Behera B. Study of clinical profile of patients presenting with topical steroid-induced facial dermatosis to a tertiary care hospital. Indian Dermatol Online J. 2020;11:208-11.
11. Saraswat A, Lahiri K, Chatterjee M, Barua S, Coondoo A, Mittal A, et al. Topical corticosteroid abuse on the face: A prospective, multicenter study of dermatology outpatients. Indian J Dermatol Venereol Leprol. 2011;77:160–6.
12. Kakkar S, Sharma PK. Topical steroid-dependent face: Response to xylometazoline topical. Indian J Drugs Dermatol. 2017;3:87-9.
13. Litt JZ. Steroid-induced rosacea. Am Fam Physician. 1993;48:67-71.
14. Dey VK. Misuse of topical corticosteroids: A clinical study of adverse effects. Indian Dermatol Online J. 2014;5:436–40.
15. Inakanti Y, Thimmasarthi VN, Anupama Kumar S, Nagaraj A, Peddireddy S, et al. Topical corticosteroids: Abuse and Misuse. Our Dermatol Online. 2015;6:130-4.
16. Lu H, Xiao T, Lu B, Dong D, Yu D, Wei H, et al. Facial corticosteroid addictive dermatitis in Guiyang City, China. Clin Exp Dermatol. 2010;35:618-21.
17. Sonthalia S, Jha AK, Sharma R. The role of dermoscopy in a topical steroid-damaged face. Dermatol Pract Concept. 2018;8:166-7.
18. Jakhar D, Kaur I. Dermoscopy of topical steroid damaged/dependent face. Indian Dermatol Online J. 2018;9:286-7.
19. Bhat YJ, Keen A, Hassan I, Latif I, Bashir S. Can dermoscopy serve as a diagnostic tool in dermatophytosis? A pilot study. Indian Dermatol Online J. 2019;10:530-5.
20. Errichetti E. Dermoscopy of inflammatory dermatoses (inflammoscopy): An up-to-date overview. Dermatol Pract Concept. 2019;9:169-80.
21. Lallas A, Apalla Z, Lefaki I, Sotiriou E, Lazaridou E, Ioannides D, et al. Dermoscopy of discoid lupus erythematosus. Br J Dermatol. 2013;168:284-8.
2. Valencia IC, Kerdel FA. Topical glucocorticoids. In: Fitzpatrick T, editor. Dermatology in General Medicine. 5 th ed. New York:McGraw-Hill; 1999p.2713-7.
3. Lahiri K,Coondoo A. Topical steroid damaged/dependent face(TSDF) : An entity of cutaneous pharmaocodependence.Indian J Dermatol 2016; 61:265 -72.
4. Coondoo A.Topical corticosteroid misuse: The Indian scenario.Indian J Dermatol 2014;59:451-5.
5. Hameed AF.Steroid dermatitis resembling rosacea : A clinical evaluation of 75 patients.ISRN Dermatol 2013;2013:491376.
6. Tatu AL.Topical steroid induced facial rosaceiform dermatitis. Acta Endocrinol(Buchar)2016;12:232-3.
7. Sethi S, Chauhan P. Jindal R. Bisht YS. Dermoscopy of topical steroid-dependent or damaged face: A cross-sectional study. Indian J Dermatol Venereol Leprol 2022;88:40-6.
8. Menzies SW, Ingvar C, McCarthy WH. A sensitivity and specificity analysis of the surface microscopy features of invasive melanoma. Melanoma Res. 1996;6(1):55–62.
9. Argenziano G, Soyer HP. Dermoscopy of pigmented skin lesions—a valuable tool for early diagnosis of melanoma. Lancet Oncol. 2001;2(7):443–449.
10. Jain S, Mohapatra L, Mohanty P, Jena S, Behera B. Study of clinical profile of patients presenting with topical steroid-induced facial dermatosis to a tertiary care hospital. Indian Dermatol Online J. 2020;11:208-11.
11. Saraswat A, Lahiri K, Chatterjee M, Barua S, Coondoo A, Mittal A, et al. Topical corticosteroid abuse on the face: A prospective, multicenter study of dermatology outpatients. Indian J Dermatol Venereol Leprol. 2011;77:160–6.
12. Kakkar S, Sharma PK. Topical steroid-dependent face: Response to xylometazoline topical. Indian J Drugs Dermatol. 2017;3:87-9.
13. Litt JZ. Steroid-induced rosacea. Am Fam Physician. 1993;48:67-71.
14. Dey VK. Misuse of topical corticosteroids: A clinical study of adverse effects. Indian Dermatol Online J. 2014;5:436–40.
15. Inakanti Y, Thimmasarthi VN, Anupama Kumar S, Nagaraj A, Peddireddy S, et al. Topical corticosteroids: Abuse and Misuse. Our Dermatol Online. 2015;6:130-4.
16. Lu H, Xiao T, Lu B, Dong D, Yu D, Wei H, et al. Facial corticosteroid addictive dermatitis in Guiyang City, China. Clin Exp Dermatol. 2010;35:618-21.
17. Sonthalia S, Jha AK, Sharma R. The role of dermoscopy in a topical steroid-damaged face. Dermatol Pract Concept. 2018;8:166-7.
18. Jakhar D, Kaur I. Dermoscopy of topical steroid damaged/dependent face. Indian Dermatol Online J. 2018;9:286-7.
19. Bhat YJ, Keen A, Hassan I, Latif I, Bashir S. Can dermoscopy serve as a diagnostic tool in dermatophytosis? A pilot study. Indian Dermatol Online J. 2019;10:530-5.
20. Errichetti E. Dermoscopy of inflammatory dermatoses (inflammoscopy): An up-to-date overview. Dermatol Pract Concept. 2019;9:169-80.
21. Lallas A, Apalla Z, Lefaki I, Sotiriou E, Lazaridou E, Ioannides D, et al. Dermoscopy of discoid lupus erythematosus. Br J Dermatol. 2013;168:284-8.
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Published
Feb 22, 2025
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How to Cite
Hardik Lohiya, Rajendra Shinde, & Dr. Snehal Navande. (2025). DERMOSCOPIC FINDINGS SECONDARY TO TOPICAL STEROID APPLICATION OVER FACE: A CROSS SECTIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 1266-1271. https://doi.org/10.53555/674rmy49
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Author Biographies
Hardik Lohiya
Junior Resident, Department of Skin and VD, Dr BST Rural Hospital and Medical College, Talegaon Dabhade, Maharashtra, India.
Rajendra Shinde
Professor, Department of Skin and VD, Dr BST Rural Hospital and Medical College, Talegaon Dabhade, Maharashtra, India.
Dr. Snehal Navande
Assistant Professor, Department of Skin and VD, Dr BST Rural Hospital and Medical College, Talegaon Dabhade, Maharashtra, India.
How to Cite
Hardik Lohiya, Rajendra Shinde, & Dr. Snehal Navande. (2025). DERMOSCOPIC FINDINGS SECONDARY TO TOPICAL STEROID APPLICATION OVER FACE: A CROSS SECTIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 1266-1271. https://doi.org/10.53555/674rmy49