Dermoscopic Assessment of Topical Steroid-Dependent Damaged Face: An Observational Study

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Abstract (English)

Abstract
Aim: This study was undertaken to characterize dermoscopic features of TSDF and to correlate them with
potency and duration of application of the TCS.
Methods: The present study was conducted in the Department of Skin and VD, and 200 cases were included in
the study. Patients (18 years or above) with clinical symptoms and signs suggestive of TSDF (redness, itching,
acne, burning, swelling, photosensitivity, pigmentation and atrophy) and with history of application of TCS on
the face for a period of more than one month were included in the study after obtaining written informed
consent. Institutional Ethics Committee approval was obtained before the commencement of the study.
Results: Females (75%) constituted the majority as compared to males. Most of the patients belonged to the age
group of 18–30 years (55%) with a mean age of 34.6 ± 8.2 years. Duration of TCS application ranged less than
one year and 1-10 years was 45% patients each. 160 (80%) patients had received some form of formal
education, while 40 (20%) patients were illiterate. Presenting complaints of the patients were redness in 150
(75%), itching in 140 (70%), pigmentation in 110 (55%), burning in 124 (62%) and acne in 80 (40%) patients.
Clinical findings noted in the patients were erythema in 170 (85%), hyperpigmentation in 170 (85%), and
hypertrichosis in 120 (60%) followed by telangiectasia in 100 (50%) and wrinkles in 70 (35%). Polygonal and
Y-shaped vessels, though, are categorized under linear vessels with branches, the term Y-shaped vessel was
used when only one lateral branch was visible and polygonal vessel was used if multiple branches forming a
network were seen. Comparison of dermoscopy findings with their corresponding clinical finding revealed that
red diffuse areas, vessels, brown globules, white structureless areas, desquamation, hypertrichosis and white hair
were observed in a statistically higher proportion of cases dermoscopically.
Conclusion: Dermoscopy in TSDF can help dermatologists in a multitude of ways from confirming the
diagnosis to differentiating from other causes of red face and predicting the approximate duration of TCS abuse.