A cross-sectional study to characterise the topical steroid dependent face by dermoscopy at a tertiary care centre

The occurrence of topical steroid dependent face (TSDF) in India has become widespread because of the abuse of creams containing steroids. Of late, many studies have been undertaken about topical steroid dependent face. Only few studies have demonstrated the dermoscopic features of this condition. Hence, we undertake a research to study the characteristic features of topical steroid dependent face by dermoscopy. A total of 398 patients who have applied topical steroid creams for more than one month and with symptoms indicative of topical steroid dependent face like redness, itching, burning, increased hair growth, acne were included in the study. The demographic, clinical and dermoscopic features were noted in such patients. These dermoscopic features were correlated with the clinical features and potency of steroid creams using Chi- square test. Statistical analysis was done using standard statistical software, ‘p’ value less than 0.05 was considered statistically significant. 398 cases were included in the study. The mean age of the patients was 30.22 ± 5.7 years. The duration of topical corticosteroid application was 1-3 months in 30.15% patients, 3-6 months in 32.66% patients. Melasma and other hyperpigmentary causes was the most common cause of steroid usage in 32.16% patients. The most prevalent steroid used was 0.1% Betamethasone valerate. The most common presenting complaints were with itching (70.35%) and redness (69.84%). The dermoscopic features included mainly diffuse red areas (93.96%), terminal hair (75.87%), telangiectasias (74.87%) and brown globules (73.86%). Terminal hair, telangiectasias, focal white areas, white hair were seen on dermoscopy in statistically higher proportion of cases. Atrophy of skin, telangiectasias, red skin, hypertrichosis, easy bruisability and acneiform eruptions are the common clinical features of TSDF in our cohort. Dermoscopic findings along with these clinical features aid in meticulous diagnosis, differentiating it from other dermatological disorders. Hence, dermoscopic evaluation of TSDF provides an easy, diagnostic and time saving procedure that aids in quick detection and helps in management of such cases.