Severe Striae and Steroid Acne as Side Effects Caused by Long-term Systemic Corticosteroid Treatment

Authors: Evi Arisandi, Ivan Kurniadi, Airin R Nurdin, Widya Widita, Khairuddin Djawad

Abstract

Introduction: Systemic corticosteroids are often used in various fields of medicine, including dermatology. The anti-inflammatory and immunosuppressive properties of corticosteroids make this agent the first-line option in many disorders such as autoimmune and bullous diseases. However, there are also potential side effects and dermatologists who prescribe corticosteroids have to be aware of them.

Case Summary: We report a 16-year-old girl with a history of taking oral methylprednisolone in the past 8 months who came with a acne-like eruption on the face, chest, and extremities as well as reddish lines on various parts of the body. Physical examination revealed monomorphic papules on the facial, thorax, and superior and inferior extremities region. Striae was found in the bilateral femur, abdomen, and mammary region. The patient was diagnosed with steroid acne and striae distensae rubra. Treatment using combination of topical clindamycin and tretinoin showed clinical improvement of the steroid acne after three months of therapy. However, no improvement was observed on the striae despite topical application of tretinoin and Centella asiatica extract.

Conclusion: This case demonstrates the importance of understanding the pathophysiology and clinical manifestations of cutaneous side effects that may result from chronic systemic corticosteroids administration as well as the current evidence-based management.

 

Citation

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Keywords

side effects, steroid acne, striae, systemic corticosteroids

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