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Category: Volume 07 Issue 05 May 2019
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Title: An observational study to evaluate the dermatological manifestations of topical corticosteroid abuse on face

Authors: Dr Amit Chauhan, Dr Ghanshyam Verma, Dr Gita Ram Tegta, Dr Vinay Shanker, Dr Ajeet Negi, Dr Kuldeep Verma

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.50

Abstract

Background: Introduction of topical corticosteroids (TC) by Sulzberger and Witten in 1952 led to the emergence of a new therapeutic era in dermatology. But soon the usefulness of these medication became a double-edged sword, owing to their misuse due to easy over the counter availability. The study is aimed at evaluating the range of side effects on the face from misuse of topical steroids.

Aim and Objectives: The primary outcome measures were to find out the most common steroid being used and the reason for its use. Secondary outcome measures were to find the age group and the gender most commonly affected, duration of steroid use, source of these prescriptions, source of procurement and whether the patient is aware of these side effects or not.

Materials and Methods: A total of 322 patients, diagnosed with topical corticosteroid induced face damage attending the outdoor patient department over a period of one year were included in the study. They were examined thoroughly and data obtained was recorded on designed proformas.

Results: Most common steroid being used was Betamethasone vale rate (38.82) mainly for melasma. Most vulnerable age group for TC misuse was between 20 to 39 years and majority (83%) were females. More than half of study group patients (55%) belonged to rural area. Majority were educated population as 34.47% were graduates. In about 64% cases, suggestion for starting TC was given by friends, relatives and neighbors. Steroid induced rosacea (55.59%) was the most common presentation.

Conclusion: The main responsibility for the misuse of topical corticosteroids in our study could be attributed to chemists, the patient himself/herself, friends and family. Apart from this strict implementation of the Government policies is the need of the hour.

Keywords: Rosacea, Dermatitis, Steroids, Acne Vulgaris.

Key Message: Easy availability and rapidity of symptomatic relief that the patient gets in almost any dermatosis remain the root cause behind widespread steroid misuse. Educational and legal approaches need to go hand in hand to curb this rising epidemic of steroid abuse.

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Corresponding Author

Dr Ghanshyam Verma

Associate Professor, Dept of Dermatology, Venereology, Indira Gandhi Medical College Shimla, HP. India

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