Evolution From Essentiality To Exploitation: Cutaneous Dermatoses To Mishandling Of Topical Corticosteorids

Research Article
Naina Jain., Arvind Krishna., Bhagirath Singh Rathore and Garima Singh
DOI: 
http://dx.doi.org/10.24327/ijrsr.2017.0812.1290
Subject: 
science
KeyWords: 
Topical corticosteroid Misuse, Dermatology.
Abstract: 

Misuse of corticosteroids, either topical or systemic, has been alarming to the dermatologists in the recent years that results in concerning, hard-to-treat cutaneous dermatoses. Objectives: We aim to study the clinical pattern and relative frequency of cutaneous adverse effects induced by misapplication of topical corticosteroids. Materials and Methods: A single contact, descriptive clinical trial including 300 patients with history and signs suggestive of topical corticosteroid abuse, presenting to the out-patient department of dermatology in a tertiary hospital. Results: Most frequent indication for use was acne vulgaris (39.7%), followed by for various infections (30.7%), mostly by individuals aged between 19 and 25 years (41%). The commonest topical preparation exploited was betnovate, containing betamethasone valerate 0.1% (58.3%), belonging to the potency class III, with large number of patients applying the concerned product once a day (69.33%), intermittently (75.0%) and using an amount of less than one fingertip unit (57.3%); frequently recommended by one’s friends/relatives (36.0%). Most patients started experiencing problems after application of the concerned product between 1 and 6 months (44.0%). Major related symptoms complained of were photosensitivity (71.9%) and itching on withdrawal over the face (61.4%) and, 5 most common signs observed were hypertrichosis (49.3%), acneiform eruptions (45.3%), facial erythema (37.7%), infections (36.3%) and cutaneous atrophy (36.3%). Conclusion: The evolution of this essential class of drugs over time has led to their exploitation, in turn resulting in preventable adverse effects. Therefore, it is of utmost importance that consistent steps be taken against their abuse, particularly byspreading the right word and by discouraging their over-the-counter dispense.