A Descriptive Study of Patients Presenting With Topical Steroid Damaged/Dependent Face (TSDF) to a Tertiary Care Center in Northern India

Introduction Topical steroid damaged/dependent face (TSDF) is defined as the semi-permanent or permanent damage to the skin of the face precipitated by the irrational, indiscriminate, or prolonged use of topical corticosteroids (TCs), resulting in various cutaneous signs and symptoms and psychological dependence on the drug. The objective was to determine the clinical spectrum of TSDF. Methods This was an observational cross-sectional study conducted between May 2021 and April 2022, comprising 100 consecutive patients of TC-induced facial dermatoses who visited the skin and venereal disease OPD of a tertiary care hospital in northern India. Any case with a negative history of TC abuse was excluded from the study. Result The study included 100 subjects of TSDF. Females outnumbered males and the age of the patients ranged from 12 to 55 years with a mean age of 27.6 ± 10.07 years. The majority of patients used TCs on the face for pre-existing acne (41%), followed by melasma (20%). Over-the-counter (63%) was the most common method of acquiring TCs, followed by prescriptions from non-qualified persons (17%) and those provided by friends and relatives (9%). Mometasone (41%) was found to be the most commonly misused TC, followed by clobetasol (31%), and betamethasone (29%). The most common morphological presentation was erythema (42%), followed by acneiform eruptions (22%), steroid-induced rosacea (21%), hyperpigmentation (20%), hypertrichosis (5%) and perioral dermatitis (3%). Conclusion This study highlights the impact of misuse of TCs on the face in a single-center setting and provides a detailed description of the associated factors. Such studies could play a crucial role in addressing this issue. Moreover, strict enforcement of regulations on pharmaceutical companies and non-qualified individuals prescribing TCs could help in decreasing this growing health hazard.