TOPICAL STEROID INDUCED FACIAL ROSACEIFORM DERMATITIS.

Abstract

Abuse of topical steroids on the face for long periods of time is a condition that needs time to cure and also methods to better observe the clinical features and for the follow-up after the cessation of steroids. To investigate which are the most prominent dermoscopic features of the Topical Steroid Induced Facial Rosaceiform Dermatitis(TSIFRD). All 40 patients showed telangiectasias (100%) and dermoscopic polygonal vessels. 80% of the patients had dermoscopic features for Demodex Folliculorum, 80% had visible and dermoscopic pustules, 75 % had visible erythema on the face and by dermoscopy they all had red diffuse areas. The atrophy was clinically visible at 4 patients (Fig. 1a) as a severe skin thinning, but dermoscopy revealed also atrophic areas at another 4 as white structureless areas between vessels (Fig. 1b). The patients with dermoscopic atrophy were using 2 mometasone furoat, 6 clobetasol propionate - one of them in the periocular area developed a very strong clinically atrophy and also glaucoma but the cortisole levels were normal. Dermoscopy is a tool for early detection of the infraclinical signs of TSIFRD by dermoscopic features: polygonal vessels, telangiectasias, scales, depressible erythema, pustules, Demodex plugs and tails, atrophy.