Prolonged application of a topical corticosteroid can result in a dermatitis.


Clinical features:

(1) prolonged application (2 months or more) of a topical corticosteroid to the skin, even low-dose.

(2) persistent erythema in the area treated with topical corticosteroid that may mimic rosacea

(3) increased skin fragility

(4) variable dryness

(5) variable pruritus

(6) variable burning

(7) variable papules, pustules and/or infection


Therapy may include:

(1) discontinuation of the topical corticosteroid

(2) doxycycline

(3) indomethacin

(4) symptomatic therapy for dryness, burning and pruritus


A rebound in the dermatitis may occur once therapy is stopped.


The diagnosis may be complicated if the original reason for the steroid therapy is still present or if another kind of dermatitis occurs.


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