Characterization of isolated and integrated clinical and dermoscopic features of topical steroid-dependent/damaged face: A study from central India

ABSTRACT Background: Topical steroid-dependent/damaged face (TSDF) is defined as semi-permanent or permanent damage to the skin of the face due to unsupervised or prolonged application of topical corticosteroids to the face. Dermoscopy is widely practiced as a non-invasive, effective technique to analyze the immediate or delayed features of TSDF. Objectives: The objective was to evaluate the clinical profile along with dermoscopic features of clinically diagnosed cases of TSDF. Materials and Methods: The study was conducted on seventy-five patients attending the Department of Dermatology, Venereology, and Leprosy between April 2021 and September 2022 with clinical symptoms and signs suggestive of TSDF. Thorough history taking, clinical evaluation, and dermoscopic examination were performed, and data was recorded in a structured proforma with a sixteen-point questionnaire. Results: Sixty-eight percent of the patients were females, yielding a female-to-male ratio of 2.1:1. The most frequently affected age group was 26–35 years (48%), with a mean age of 31.8 years. The most common topical steroid employed was beclomethasone dipropionate 0.25% (33.33%), followed by clobetasol propionate 0.05% (29.33%). The most common clinical findings observed were erythema with hyperpigmentation (74.66%), followed by erythema with telangiectasia (34.66%). The most often observed dermoscopic findings were red, diffuse areas with vessels (61.33%), red, diffuse areas with an exaggerated pigment network (52%), and clustered vellus hairs with white vellus hair (44%). Conclusion: Topical corticosteroids are commonly abused drugs seen in modern clinical practice, resulting in a plethora of symptoms and creating a paramount dermatological concern. Dermoscopy plays a cardinal evaluating role in the early discernment and establishment of TSDF besides determining the gravity of damage. Key words: Topical steroid-dependent/damaged face (TSDF), Topical corticosteroids, Dermoscopy