Steroid-induced skin changes
| Steroid-induced skin changes | |
|---|---|
 | |
| Generalized facial erythema after applying corticosteroid | |
 | |
| Specialty | Dermatology |
| Symptoms | Thin skin, stretch marks, visible small blood vessels, ulcers, infections, tinea incognita, steroid acne, steroid rosacea, purpura, trichostasis spinulosa, increase hair growth, hypopigmentation, hyperpigmentation, perioral dermatitis[1] |
| Causes | Corticosteroid; by application, injection, inhalation or by mouth[1][2] |
| Frequency | Common[3] |
Steroid-induced skin changes include atrophy, stretch marks, visible small blood vessels, ulcers, infections, tinea incognita, steroid acne, steroid rosacea, purpura, trichostasis spinulosa, increase hair growth, hypopigmentation, hyperpigmentation, and perioral dermatitis.[1][4]
It typically follows applying steroids to skin, by taking a steroid by mouth, inhaling steroids, or following injection of steroid.[1][2] Steroid creams are used widely to treat inflammatory skin diseases such as eczema and psoriasis.[5] They generally work quickly and are inexpensive, but have the potential to cause adverse skin changes.[5]
Signs and symptoms
Skin changes induced by steroids include most frequently atrophy, stretch marks, steroid rosacea, perioral dermatitis, steroid acne and purpura.[1] Less frequent effects include increase hair growth, hypopigmentation, hyperpigmentation, slow wound healing and infections.[1] Other effects include visible small blood vessels, ulcers, tinea incognita, and trichostasis spinulosa.[1][4] There may be easy bruising, redness or flushing of skin, fragile skin, itching, ochronosis, dryness of skin, pyoderma, and hair loss.[2][3] The skin of the face is particularly susceptible.[1]
Atrophy
The most frequent skin change following steroid application is thinning of the skin, seen microscopically up to 2-weeks following treatment.[1] The affected skin may appear lax, wrinkled and shiny.[1] As the skin becomes transparent, small blood vessels may be seen.[1]
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Steroid-induced atrophy
Stretch marks
Stretch marks appear similar to that seen in pregnancy and obesity.[1]
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Steroid-induced striae
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Acne
Inhaled steroids may trigger acne spots around the mouth and nose.[1] Steroids by mouth may cause an eruption of uniformly sized small bumps and pustules on the trunk and limbs.[1] Comedomes may form where steroid is applied to skin.[1]
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Steroid-induced acne
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Steroid-induced acne
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Steroid-induced acne
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Steroid-induced acne
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Steroid-induced acne
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Steroid-induced acne
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Pigment alteration
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Steroid-induced hypopigmentation
Steroid rosacea
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Steroid rosacea
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Tinea incognita
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Steroid-induced tinea incognita
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Hair growth
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Steroid-induced hypertrichosis
Peri-oral dermatitis
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Steroid-induced peri-oral dermatitis
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Infection
Typically, steroids may encourage fungal infection including tinea, candida and pityriasis versicolor.[2] Bacterial infection may result in cellulitis, and viral infection may include herpes zoster.[2]
Epidemiology
Steroid-induced skin changes are common.[3]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 Coondoo, Arijit; Phiske, Meghana; Verma, Shyam; Lahiri, Koushik (October 2014). "Side-effects of topical steroids: A long overdue revisit". Indian Dermatology Online Journal. 5 (4): 416. doi:10.4103/2229-5178.142483. ISSN 2229-5178. Archived from the original on 2023-02-19. Retrieved 2023-04-21.
- ↑ 2.0 2.1 2.2 2.3 2.4 Oakley, Amanda (February 2016). "Systemic steroids (corticosteroids) | DermNet". dermnetnz.org. Archived from the original on 18 April 2023. Retrieved 21 April 2023.
- ↑ 3.0 3.1 3.2 Kannan, S; Khan, W; Bharadwarj, A; Rathore, BS; Khosla, PP (November 2015). "Corticosteroid-induced cutaneous changes: A cross-sectional study". Indian journal of pharmacology. 47 (6): 696–8. doi:10.4103/0253-7613.169583. PMID 26729971. Archived from the original on 2023-04-22. Retrieved 2023-04-22.
- ↑ 4.0 4.1 Abraham, A; Roga, G (September 2014). "Topical steroid-damaged skin". Indian journal of dermatology. 59 (5): 456–9. doi:10.4103/0019-5154.139872. PMID 25284849. Archived from the original on 2022-12-08. Retrieved 2023-04-21.
- ↑ 5.0 5.1 Niculet, E; Bobeica, C; Tatu, AL (2020). "Glucocorticoid-Induced Skin Atrophy: The Old and the New". Clinical, cosmetic and investigational dermatology. 13: 1041–1050. doi:10.2147/CCID.S224211. PMID 33408495. Archived from the original on 2023-04-23. Retrieved 2023-04-23.