Misuse Of Steroids Research Articles

Toxic non-inflammatory fungal keratitis.

Purpose:To report a new entity called “toxic non-inflammatory fungal keratitis.”Methods:Eyes manifesting infective keratitis with a history of prior administration of topical steroids were included in the study. The details pertaining to the type of injury, duration of injury, and primary treatment for corneal trauma were meticulously documented. The corneal tissues were scraped from the patients and were analyzed for fungal filaments by using a 10% KOH mount under a compound microscope. Moreover, these scraped materials were plated on blood agar and Sabouraud dextrose agar plates.Results:The corneal ulcers displayed a disproportionately reduced intensity of pain and improved visual acuity. Further, 10% KOH revealed profuse fungal filaments with few inflammatory cells in all the patients. The anterior chamber cells and flare were either reduced or entirely absent. There was no evidence of lid edema and surrounding corneal edema in any of the patients. The mean healing period was 28.8 days (standard deviation (SD): 10.05). The KOH mount revealed the presence of confluent fungal hyphae with a few inflammatory cell infiltrates. The Aspergillus species and Fusarium species were found in 47% and 40% of the cases, respectively.Conclusion:Toxic non-inflammatory fungal keratitis following steroid therapy needs to be considered in fungal ulcers with disproportionately less pain and good visual acuity. The fungal ulcers with altered clinical signs of classical inflammation need to be assessed for topical steroid misuse.

Misuse of Steroids, Other Performance Enhancers Slips Under Radar

Misuse of Steroids, Other Performance Enhancers Slips Under Radar

A Clinico Mycological Study of Tinea Pseudoimbricata.

Introduction:Tinea pseudoimbricata is a variant of dermatophytosis characterized morphologically by concentric scaly rings resembling tinea imbricata with an culture isolate other than Trichophyton concentricum. To date, no large case report series is available.Aim:To study the clinical profile and the fungus isolated in patients with tinea pseudoimbricata.Materials and Methods:In this case series, all the patients with tinea imbricata with an isolate other than Trichophyton concentricum were subjected to a detailed history and clinical examination. Scrapings of the scales were investigated with potassium hydroxide examination and culture in Sabouraud Dextrose Agar enriched with cycloheximide and chloramphenicol. The results obtained were tabulated and analyzed.Results:A total of 42 patients fulfilling the above culture criteria were included in the present study. A majority were in the age group of 21–40 years (54.70%) with a male preponderance (M:F = 2:1). All the patients had abused steroids for more than 4 weeks and had multiple site involvement. Trichophyton tonsurans (42.8%) was the predominant isolate cultured, followed by Trichophyton mentagrophytes.Conclusion:Hence, as per our study, tinea pseudoimbricata is encountered more often nowadays due to the misuse of topical steroids and to diagnose tinea pseudoimbricata culture is mandatory. The morphology of concentric rings is not restricted to Trichophyton concentricum, but can occur with other species depending on the clinical scenario.

Steroid abuse, quality of life, and various risk factors in dermatophytosis: a cross-sectional observational study from a tertiary care center in northern India

Dermatophytosis is a superficial cutaneous mycosis and is steadily progressing to epidemic proportions in India. Various factors such as steroid overuse and misuse are currently making its treatment challenging. The study examines various sociodemographic characteristics, clinical factors, and steroid abuse in patients with dermatophytosis and also assess their quality of life (QOL). A hospital‑based cross‑sectional study was carried out for a period of 1 year among adult patients with dermatophytosis after obtaining informed written consent. Sociodemographic and clinical details were recorded, and QOL was assessed with the Dermatology Life Quality Index (DLQI) questionnaire. Among 550 patients analyzed, the most common dermatophytosis was tinea (n = 408/550, 74.18%), dominated by tinea cruris and tinea corporis. Steroid abuse was frequent (n = 511/550, 92.90%), the most common being clobetasol propionate (n = 26/52, 50%). Hypopigmentation and atrophy were the most common side effects (53.52%). The mean DLQI was 14.44 ± 7.29 in males and 15.78 ± 6.26 in females. DLQI scores were statistically influenced (p < .05) by steroid abuse, low socioeconomic status, young adult status, widespread tinea, and poor hygiene. Dermatophytosis was found to have a significant adverse impact on QOL. As seen in this study, the widespread abuse of steroids may be a leading cause of the emergence of recalcitrant tinea in India.

Generalized pustular psoriasis and Cushing’s syndrome in childhood due to corticosteroids misuse

Background : Generalized pustular psoriasis (GPP) is characterized clinically by yellow ish sterile pustules surrounded by erythema. GPP in children is very rare and may appear following steroid withdrawal in psoriasis vulgaris. Case Illustration : A 14-year-old female presented to the emergency unit with generalized erythematous plaques and multiple pustules with lake of pus after abruptly stopped oral and topical corticosteroid for two weeks. The patient had used topical and oral corticosteroids for almost a year to treat psoriasis. Physical examination revealed moderately ill and tachycardic, with short stature, moon face, amenorrhea, and multiple erythematous plaques with multiple pustules and lake of pus along with red-purple striae all over the body. Discussion: Adverse effects of steroid-induced adrenal insufficiency are time-dependent and generally reversible. Gradual discontinuation of steroids must adhere to physiological dose of steroids, mostly in 3.49 &plusmn; 2.92 months. Other treatments available are emollients, salicylic acid, calcipotriol, coal tar, topical steroids, phototherapy, retinoids, and cyclosporine. Topical steroids cannot be the main therapy in severe psoriasis due to the possible side effects of excessive usage. Conclusion : Misuse of topical and systemic steroid in children could lead to Cushing&rsquo;s syndrome, a multisystem disorder resulting from prolonged exposure to excess glucocorticoids, either both systemic or topical. Children could easily develop systemic reactions to topical steroids due to their higher total body surface area to body weight ratio. &nbsp; Keywords : childhood, Cushing&rsquo;s syndrome, pustular psoriasis, steroid misuse

Anabolic-Androgenic Steroid Misuse: Mechanisms, Patterns of Misuse, User Typology, and Adverse Effects.

Anabolic-androgenic steroids (AAS) encompass a broad group of natural and synthetic androgens. AAS misuse is highly prevalent on a global scale, with the lifetime prevalence of AAS misuse in males being estimated to be around 6%, with 15 to 25% of male gym attendees using it at any one time. AAS are associated with sudden cardiac death, neuropsychiatric manifestations, and infertility. The average AAS user is unlikely to voluntarily declare their usage to a physician, with around 1 in 10 actively engaging in unsafe injection techniques. The aim of this paper is to review the current evidence base on AAS with emphasis on mechanisms of action, adverse effects, and user profiles that are most likely to engage in AAS misuse. This paper also reviews terminologies and uses methods specific to the AAS user community.

Investigation of the Prevalence of Anabolic Steroid Misuse, as Well as the Awareness Level and Attitude toward its Negative Effects among the Male Bodybuilder Athletes in Kermanshah, Iran, in 2019

Investigation of the Prevalence of Anabolic Steroid Misuse, as Well as the Awareness Level and Attitude toward its Negative Effects among the Male Bodybuilder Athletes in Kermanshah, Iran, in 2019

The Tragedy of a Strong Muscle and a Weak Heart: Complications of Anabolic-Androgenic Steroid Misuse

Misuse of anabolic-androgenic steroids (AAS) to boost performance and appearance is rising in the United States (US) with approximately one million people experiencing dependence. Long-term AAS misuse can lead to cardiovascular pathology but rarely cardiogenic shock. We report the case of an acute ischemic stroke secondary to an intracardiac thrombus in a patient with biventricular failure and cardiogenic shock associated with AAS misuse. Discontinuation of AAS and institution of guideline-directed medical therapy might reverse AAS-related heart failure.

Withania somnifera ameliorates nandrolone-decanoate-induced brain damage in rats by inhibiting cell death, prodynorphin mRNA expression and acetylcholinesterase activity

The misuse of anabolic-androgenic steroids by athletes and non-athletes causes harmful effects on the central nervous system. In Ayurvedic medicine, Withania somnifera (WS) as an herbal drug has been reported for several functions including adaptogenic, anticonvulsant, cytoprotective and antioxidant. The present study investigated the neuroprotective functions of WS (100, 200 and 400 mg/kg body weight) in nandrolone decanoate (ND)-induced (16 mg/kg body weight) brain injury in male Wistar rats. ND was injected intramuscularly twice weekly for 4 weeks. The water emulsion of WS root powder was administered orally once daily for 30 days to ND-treated rats. At the end of the experiment, anxiety-like behaviour was assessed in rats using the elevated plus maze. Haematoxylin-and-eosin-stained coronal sections of the parietal cortex and hippocampus of ND rats showed severe alterations in brain histology compared with control rats. Acetylcholinesterase (AChE) activity in the striatum and prodynorphin gene expression in the hippocampus was significantly elevated in the ND group compared with the control group. Treating ND induced rats with various doses of WS significantly reversed the brain damage, anxiety behaviour, increased striatal AChE activity and reduced prodynorphin gene expression in the hippocampus. In conclusion, WS extract can be used as a neuroprotective agent to reduce the effects of anabolic steroids.

Multidimensional Separations of Intact Phase II Steroid Metabolites Utilizing LC–Ion Mobility–HRMS

The detection and unambiguous identification of anabolic-androgenic steroid metabolites are essential in clinical, forensic, and antidoping analyses. Recently, sulfate phase II steroid metabolites have received increased attention in steroid metabolism and drug testing. In large part, this is because phase II steroid metabolites are excreted for an extended time, making them a potential long-term chemical marker of choice for tracking steroid misuse in sports. Comprehensive analytical methods, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS), have been used to detect and identify glucuronide and sulfate steroids in human urine with high sensitivity and reliability. However, LC-MS/MS identification strategies can be hindered by the fact that phase II steroid metabolites generate nonselective ion fragments across the different metabolite markers, limiting the confidence in metabolite identifications that rely on exact mass measurement and MS/MS information. Additionally, liquid chromatography-high-resolution mass spectrometry (LC-HRMS) is sometimes insufficient at fully resolving the analyte peaks from the sample matrix (commonly urine) chemical noise, further complicating accurate identification efforts. Therefore, we developed a liquid chromatography-ion mobility-high resolution mass spectrometry (LC-IM-HRMS) method to increase the peak capacity and utilize the IM-derived collision cross section (CCS) values as an additional molecular descriptor for increased selectivity and to improve identifications of intact steroid analyses at low concentrations.

A fungal epidemic in viral pandemic

Introduction: Covid 19 pandemic continues to be a major health problem worldwide. Despite being more than one year into pandemic, the treatment remains controversial and systemic steroids have shown some benefit. On the flip side rampant use of glucocorticoids has potentially resulted in secondary bacterial and fungal infection. In the early part of pandemic less than 1 % cases were fungal. In 2nd wave of pandemic it has been increasing as an opportunistic infection in covid 19 recovered patients. Mucormycosis infection typically effects immunocompromised individuals, uncontrolled diabetics mellitus, acquired immunodeficiency syndrome, malignancy. Here i report association of covid19, diabetes mellitus, steroid risk in mucormycosis. Material and methods: A retrospective observational study conducted at tertiary centre, involving all patients with mucormycosis during may 2021 to july 2021.Twenty patients diagnosed with mucormycosis were included in this study. The demographic features, predisposing conditions, clinical features, radiological manifestation and patients outcome were collected from medical records. Results: Predisposing factors were identified in 20 patients- 5 patients are female, 15 patient are male with diabetics in 17 patients with history of covid in 14 patients, 3 patients non covid. History of covid in 17 patients, 3 non covid patients. Steroids usage was seen in 15 patients of which 14 patients are diabetic and 1 non-diabetic, 11 patients had uncontrolled diabetics.1 patient had ckd. All patients tissue samples collected and submitted for histopathological examination showed fungal hyphae. All our patients MRI was done and extent of involvement of sinuses involvement in 12 patients, rhino orbital in 6 patients, rhino orbital cerebral in 2 patients.18 patients were recovered and 2 patients were expired. Discussion: Diabetes mellitus directly contributes to mucormycosis risk by hyperglycation of iron sequestering upregulation of cell receptors, defects in phagocytic function and expression of receptors that mediate host cell invasion. Covid 19 has been shown to affect the beta cells of pancreas, causing metabolic derangement leading to diabetes mellitus. Overuse, misuse and rampant use of steroids in covid 19 patients have a increased chance of mucormycosis. Diabetes mellitus when combined with SARS cov 2 virus and steroid therapy, appears to be a vicious cycle of hyperglycemia and immunosuppression, which leads to mucormycosis Conclusion: The second wave of covid 19 in India has led to more deaths than first wave and in just few weeks.b.1.617.2 delta variant became dominant strain, more infectious and somehow promoting entry of mucorales in to patients. It was declared as epidemic on 21 st may 2021 as there were huge rise in cases. Strict glycemic control, proper sanitization and covid preventive measures should be strictly followed to prevent this deadly fungal infection.

Mucormycosis: time to address this deadly fungal infection

Mucormycosis: time to address this deadly fungal infection

The Prevalence of Anabolic-Androgenic Steroid Misuse in Iranian Athletes: A Systematic Review and Meta-Analysis

Background:Due to widespread abuse of anabolic-androgenic steroids among professional athletes and amateur sportsmen and their health-related problems, determining the prevalence and the pattern of anabolicandrogenic steroid misuse at the national level seems to be vital for designing efficient preventive and educational measures.Methods:This systematic review and meta-analysis was conducted via comprehensive searches of the electronic databases including PubMed, MedLine, Scopus, Google Scholar and National Persian Databases including SID, Magiran, IranDoc (between 1980 and Dec 2019 in English and Persian languages) and also from citations in the selected papers. Overall, 39 articles met the criteria and were included in qualitative and quantitative synthesis.Results:The overall prevalence rate of anabolic-androgenic steroid misuse in the Iranian athletic population was 36.2% (95% confidence interval (CI), 29–43) with significant heterogeneity between studies (I2=99.0%, P<0.001). Prevalence rate of anabolic-androgenic steroid misuse among elite, male and younger athletes was higher (P<0.05). Moreover, prevalence rate of anabolic-androgenic steroid misuse among body-building athletes (36.3%) was higher compared to other athletes (30.9%), (P<0.001).Conclusion:Due to the higher prevalence of anabolic-androgenic steroids misuse in Iran compared to global statistics and the potential for serious adverse effects, preventive strategies and policies should be regarded as a real concern for public health.

Awareness and attitude of medical students over the misuse of topical steroids- Prospective study in 3rd year medical students in a Medical college, Tamil Nadu

Topical corticosteroid’s anti-inflammatory action is the common property that induces the misuse of the topical steroids. Most of the time, even a medical graduate is misguided about the steroidal molecules in the combination formulation for the treatment of infections which gives temporary relief of symptoms such as itching and lightening effect in short term, But on long term will lead onto local adverse reactions such as dryness, burning sensation and striae etc.To analyse the knowledge of the medical students towards topical steroids and bridges the gaps in the knowledge.6 semester students who gave consent for the inclusion in the study were enrolled and a pretested validated questionaries were given to be filled. After the pretest, a video presentation of the topic was presented and the post test was given with the same format after 3 months. Results were analyzed using SPSS software.75% of the students heard about the topical steroids, out of which 57% were irrelevant steroid combination and 36% were Kligman’s formula. On comparing the pre and post test results, there is significant increase in the awareness regarding long term use of topical steroids (P&amp;#60;0.02) and the knowledge of the adverse events (P&amp;#60;0.01) and also the knowledge regarding the potency and area of application (P=0.003).Precise and adequate knowledge regarding topical steroid should be initiated in the early clinics in undergraduate curriculum and should be propagated or reinforced throughout the curriculum to prevent the misuse of topical steroids.

Testosterone Use and Adrenal Hemorrhage

Background: Testosterone supplementation has been associated with a variety of side effects, such as polycythemia, and can potentially increase the risk of cardiovascular disease. Testosterone use has also been associated with increased thrombotic events, especially in patients with underlying hypercoagulable state. Clinical Case: A 57-year-old man presented with abdominal pain and distention. He had history of previous intramuscular (IM) and oral testosterone use for ten years. For 8 weeks prior to initial presentation, he reported using weekly IM 500mg Testosterone injections. Computed Tomography (CT) of the abdomen and pelvis revealed multiple thrombi of the portal, splenic, superior mesenteric and inferior mesenteric veins. He was started on Warfarin and discharged home. A few weeks later, he presented with similar symptoms with labs now showing an International Normalized Ratio (INR) of 10.2. Repeat CT was significant for presence of bilateral adrenal hemorrhage, measuring 2.9cm on the right and 2.4cm on the left, which were not seen on previous imaging done one week prior. During the hospital course, he was found to be hypotensive with low platelet count so Intravenous Immunoglobulin therapy was initiated for suspected catastrophic antiphospholipid syndrome (CAPS). Morning cortisol was 5.82 ug/dL (6.2–29.0) so this critically-ill patient was started on stress dose hydrocortisone, which was subsequently tapered to physiological dose after clinical improvement. Cosyntropin stimulation test was performed after withholding the prior dose of hydrocortisone. The baseline cortisol was 0.88 ug/dL (6.20–29.00ug/dL), after administration of 250mcg of Cosyntropin 30- and 60-minute cortisol levels were 1.5 ug/dL (4.3–22.4ug/dL) and 1.6 ug/dL (4.3–22.4ug/dL) respectively. Baseline ACTH of 121.0 pg/mL (7.2–63.3pg/mL), consistent with primary adrenal insufficiency. Dehydroepiandrosterone Sulfate (DHEA-S) level was 15.7 ug/dL (80.0–560.0ug/dL). Hypercoagulability workup was significant for the presence of lupus anticoagulant and antibodies positive for heparin induced thrombocytopenia, so patient was diagnosed with Antiphospholipid syndrome. Conclusion: This is a case of hypercoagulability in a patient with history of anabolic steroid misuse who developed extensive intraabdominal venous thrombosis, adrenal hemorrhage, and primary adrenal insufficiency. Adrenal vein thrombosis and hemorrhage can be life threatening sequalae of testosterone misuse and should be considered in the differential for patients with history of testosterone misuse and adrenal insufficiency.

Improper Use of Topical Corticosteroids in Tinea Infections in a Tertiary Care Hospital.

Steroid-modified tinea, also known as tinea incognito, is an infection by the dermatophytes, where the clinical morphology is modified due to corticosteroids, either systemic or topical. Rampant use of topical corticosteroids has led to increasing recurrence in tinea infections. All consenting cases of tinea presenting to outpatient department of dermatology department of Civil Service Hospital from March to August 2020 for a total of 6 months were included in this study. Tinea infection involving only the palms, soles, nails or scalp were excluded. A total of 200 patients were included in this study. Among these, 175 patients (87.5%) were using topical corticosteroids. A significant association was noted between dermatophyte infection of more than one month and topical corticosteroids use (p<0.05). This study revealed that males were using super-potent topical corticosteroids more as compared to females (p<0.05). Moreover, no association was noted between the level of education attained and the use of topical corticosteroids (p=0.91). Only 25 (12%) patients were either using correct or no topical medications during the time of consultation with the dermatologist. Among the patients using topical corticosteroids, 155 (88.6%) patients were using them on recommendation of the local pharmacist and only 2 (1.2%) patients were prescribed by a physician. In short, use of topical steroids was rampant among patients with tinea whilst 77.5% patients procured steroid topicals over-the-counter. Hence, a tougher law and strict regulatory guidelines deemed necessary to curb the unauthorized and rampant sale of these medicines.

Profiling of transcriptional biomarkers in FFPE liver samples: PLS-DA applications for detection of illicit administration of sex steroids and clenbuterol in veal calves

Administering growth promoters to meat-producing animals is strictly regulated within the European Community to preserve consumers’ safety. Nevertheless, illicit misuse of steroids and other veterinary drugs to increase animal production has still been found by National Residues Control Plans (NRCPs), mainly based on expensive targeted multi-class/multi-residue analytical methods, used for confirming quantification analysis of these residues in tissues and biological fluids. The setup of complementary novel diagnostic methods, based on indirect biomarkers of exposure to anabolic substances is, therefore, needed to update current tests available in NRCPs at the screening level, where cheaper, sensitive and untargeted methods are required. Biological effects of illicit treatment transcriptomic analysis has reached a good grade of standardization, identified by microarray and RNAseq technologies of large panels of differentially expressed gene targets (DEG) related to abuse of different classes of anabolic molecules (e.g. sex steroids, thyreostats, β2-agonists, glucocorticoids, etc.). The aim of the work was to identify a minimum set of molecular markers able to detect illicit administration of two of the most recurrent classes of growth promoters (sex steroids and B2-agonists) on formalin-fixed paraffin-embedded (FFPE) tissues, being a potentially straightforward sampling strategy at the slaughterhouse level. A PCR array to allow quantitative profiling of 48 genetic targets was, therefore, developed on FFPE liver samples from veal calves. Conventional univariate and alternative approaches based on multivariate classification methods were considered for gene expression profiling of 92 samples collected from different animal trials, where effects of nandrolone, estradiol, their combination, and clenbuterol were studied.The developed Partial Least Squares – Discriminant Analysis (PLS-DA) models show the successful setup of a novel screening strategy based on multiple transcriptional biomarkers, able to expand tested sample sizes, and consequently strengthen current NRCPs.

The Extent of Inclusion of Future Forecasts Requirements in the intermediate first-grade Science Course in Saudi Arabia: مدى تضمين متطلبات استشراف المستقبل بمقرر العلوم للصف الأول المتوسط في المملكة العربية السعودية

The study to identify the extent to which the requirements for future development are included in the science courses for the intermediate first-grade in the Kingdome of Saudi Arabia, To achieve the objectives of the study we used the descriptive-analytical approach, The tool was represented in the list of an analysis of the content of science courses for the intermediate first-grade in Saudi Arabia in light of the six axes of the specific future-forward requirements (Natural outlook, environmental outlook, food outlook, healthy outlook, community outlook, economic outlook), It includes (43) sub-requirements, applied to the sample of science courses for the first grade, in the first and second semesters of 1441-2019, The results of the study showed that the inclusion of the requirement for environmental foresight in the content of science courses for the first middle grade of science courses was (46%) Which is a moderate ratio, Followed by natural outlook with a guaranteed percentage (41%), followed by food and health outlook swelled to the same rate as (3.8%). Which is a low percentage, Then the community outlook and economic outlook came with the lowest percentages of (2.5%), also it was concluded that there are some forward-looking requirements not included in the content of science courses for the intermediate first-grade They are: genetically modified foods, preservatives additives, artificial colors, hormone therapy, laser therapy, alternative medicine, gene therapy, misuse of vitamins and steroids, traffic congestion, industry, In light of the results, several recommendations and proposals were made for the development of science curricula in light of the requirements for future development. The most important ones are attention to the main and sub-future requirements reached by the study by those responsible for the development and preparation of the curricula of intermediate first-grade sciences. And Increased attention to key and sub-future requirements that were received in small proportions in the content of intermediate first-grade science courses.

Anabolic Steroid-Induced Myocardial Infarction in a Young Male

Misuse of androgenic-anabolic steroids (AAS) has been well known to increase the risk for a cardiac problem, including acute myocardial infarction (MI). Steroids once thought a magic drug providing immediate relief to patients, also have a darker aspect of its severe side effects. AAS are widely used these days, especially in teenagers, bodybuilders, and athletes. MI is thought to be a disease of old age, but young patients with MI without risk factors draw attention to the possibility of drugs such as cocaine, AAS abuse, and amphetamine. In this article, we report the case of a 38-year-old African-American male, with a history of AAS abuse, who arrived at the emergency department with complaints of severe chest pain radiating to the left arm. An electrocardiogram (ECG) revealed ST-elevation MI (STEMI) and elevated troponin. The patient was transferred to the cardiac catheterization lab for an emergent catheterization which showed 100% stenosis of the left anterior descending artery and a drug-eluting stent was placed. An echocardiogram showed an ejection fraction of 35%. All blood workup was negative. The patient was discharged on aspirin, ticagrelor, statin, ACE inhibitor, and B-blocker after three days.Chest pain in a young patient population secondary to MI is not uncommon these days and the most important thing to evaluate is drug history, including AAS use. Athletes, bodybuilders, and others who use steroids or other drugs that are responsible for MI should be under the supervision of physicians so that the complications of steroids are ascertained, and if steroids are needed for any medical illness, proper dosage and follow-up should be emphasized. Therefore, while taking history from a patient, it is essential for physicians to be aware of this association of steroids with coronary artery disease.

Clinico-epidemiological study of topical steroid dependent face in a tertiary care hospital at Mysore

Background: Topical steroids are the most commonly prescribed drugs in dermatology. The adverse effects of steroid misuse are noticeable 3 to 4 weeks after application. Steroid rosacea, hypertrichosis and acneiform eruptions are few of them. A new entity known as topical steroid dependent face, topical steroid dependent face (TSDF) has been recently coined to encompass symptoms such as erythema, burning sensation on attempted cessation of topical steroid application.Methods: A questionnaire-based analysis was done among patients attending dermatology outpatient department of government medical college hospital, Mysore between November 2018 to May 2019. Prior approval of the institutional ethics committee, and consent of patients were obtained. A total of 200 outpatients with facial dermatosis using topical steroids on face for a period greater than one month were taken up for study.Results: The results included population across different age groups, between 16 to 60 years. 56% belonged to the age group of 16 to 30 years. Most common steroid abused was mometasone cream 0.1% (50%), betamethasone valerate cream 0.1% (24.5%) followed by clobetasol ointment 0.05% (21.5%). The major adverse effect with steroid abuse, were acne 72% facial redness 67%. Hyperpigmentation 51%, hypertrichosis 32.5% and skin atrophy 21%.Conclusions: The present study highlights and creates awareness on the burden of facial topical steroid abuse and the poor attitude towards them.