engleski

Dermatitis rosaceiformis steroidica - A common face skin disorder

Dermatitis rosaceiformis steroidica, previously described as perioral dermatitis or steroid rosacea, i not so rare facial condition in Croatia. Topical steroids are very efficacious in many skin diseases but longterm use causes side effects such as epidermal thinning, teleangiectasia, erythema, papulopustular eruptions, and bacterial, viral and mycotic superinfection. Longterm use of steroids leads first to an anti - inflammatory effect manifest on "primary dermatosis", a skin change when the patient begins with topical application, and after several months/years of the steroid use histologic and functional changes develop. The majority of patients are females with mild to heavy facial dermatitis resembling rosacea, however, male patients and children have been ever more frequently encountered. This dermatitis consists of erythema, teleangiectasias, papules and pustules, developing in three types of distribution: perioral, centrofacial, and diffuse. Our patients had applied steroids from several weeks to over 25 years, mainly for seborrheic dermatitis, rosacea and acne vulgaris bur also for other reasons such as unrecognized dermatomycosis, cosmetic cleansing and moisturizers, aftershave lotion, etc. Upon discontinuation of topical steroids, almost all patients complained of "rebound phenomena" manifesting as edema, erythema, an papulopustular eruption with itching and burning. For this reason, the patients often continued with the same or other topical steroid, thus prolonging its abuse. What did we recommend to our patients? To stop the steroids: to stop the cosmetics; to clean the skin with cold or tepid water; to use "null therapy", i.e. wet compresses and neutral creams only. n more severe cases, tetracyclines or isotretinoin led to remarcable clinical improvement in 1-4 month. Patients with unrecognized dermatomycosis are successfully treated with antimycotics.

dermatitis rosaceiformis steroidica; etiopathogenesis; symptoms; treatment

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