tag:blogger.com,1999:blog-9870114.post7991031728857093391..comments2024-03-10T08:41:32.400+00:00Comments on VIRTUAL GRAND ROUNDS IN DERMATOLOGY 2.0: Facial erythema Secondary to Topical CorticosteroidsHumane Medicine Huihttp://www.blogger.com/profile/07113291188306363130noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-9870114.post-70619446793544852662013-12-19T11:11:57.195+00:002013-12-19T11:11:57.195+00:00Hi, I was wondering whether any rebound occurred w...Hi, I was wondering whether any rebound occurred when the patient was trying to wean himself off tacrolimus 0.03%.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9870114.post-22088831726624619242012-05-16T17:42:32.121+00:002012-05-16T17:42:32.121+00:00Patient Follow-up -- May 2012: The patient is alm...Patient Follow-up -- May 2012: The patient is almost completely clear and being maintained with tacrolimus 0.03% ointment two times a week. He will wean himself off that. Louise UK's comments are important and can be found on her web site given above.Humane Medicine Huihttps://www.blogger.com/profile/07113291188306363130noreply@blogger.comtag:blogger.com,1999:blog-9870114.post-15415915233513890092012-05-16T10:08:00.698+00:002012-05-16T10:08:00.698+00:00Could we have an update as to how this man is doin...Could we have an update as to how this man is doing now? I am also going though steroid withdrawal and have been off the creams for 6 months after stopping cold turkey in December. Things are slowly improving for me. My blog is at<br />http://topicalsteroidwithdrawal.blogspot.co.uk/Louisehttps://www.blogger.com/profile/15469340247407868766noreply@blogger.comtag:blogger.com,1999:blog-9870114.post-54586008851357193182011-12-11T18:47:52.027+00:002011-12-11T18:47:52.027+00:00I am going through topical steroid withdrawal and ...I am going through topical steroid withdrawal and into 7th week, not to the face except eyelids, but primarily arms, neck, and sides of torso. Clearly the red skin syndrome Dr. Rapaport references. I attempted to taper off over summer, and as he notes in his manuscripts, it doesn't work. You indeed must stop all treatments.<br /><br />Can you please follow up on this patient's condition now and post? I would love to know how he is doing.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9870114.post-37060518818032060312010-05-22T17:43:17.173+00:002010-05-22T17:43:17.173+00:00HORRIBLE problem. He will revcover but it will ta...HORRIBLE problem. He will revcover but it will take probably over a year. Protopic usually helps a lot. Hopefully, he doesn;t have glaucoma?? that is the biggest problem. from Fran Storrs, Portland OregonHumane Medicine Huihttps://www.blogger.com/profile/07113291188306363130noreply@blogger.comtag:blogger.com,1999:blog-9870114.post-14354608371385011992010-05-22T11:11:07.050+00:002010-05-22T11:11:07.050+00:00It is Steroid induced rosacea. I prefer TIMs (Pime...It is Steroid induced rosacea. I prefer TIMs (Pimecrolimus more than tacrolimus) with oral Cap isotretinoin 5 to 10 mg/ day; sunscreens and moisturisers.<br />Weaning such apatient from steroids is a big ask. A lot of these patients take months to improve.<br />Regular follow ups with intermittent courses of Azithromycin may be needed.<br />Regards<br /> Dr Manish Pahwa<br /> New Delhi,<br />IndiaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9870114.post-50498027759758395592010-05-22T11:00:04.251+00:002010-05-22T11:00:04.251+00:00this is a common concern when u recomend topical s...this is a common concern when u recomend topical steroids on face in india.apparently there are certain over the counter(otc) steroidal products available in india which are being used as a normal face cream patient keeps on using this product for years together and lands to you with features of rosacea .(topical steroid addiction) i prefer using topical calcineurin inhibitors rather than using a weaker steroid, with anti rosacea medications , H1 blockers and sunblock .Unknownhttps://www.blogger.com/profile/04814504803905843707noreply@blogger.comtag:blogger.com,1999:blog-9870114.post-47420379289230653592010-05-21T16:57:05.645+00:002010-05-21T16:57:05.645+00:00Steroid facial erythema is one of the major skin p...Steroid facial erythema is one of the major skin problem among iraqi young patients especially females.They usually use topical clobetasole(dermovate)to the face in order to become more white or for treatment of melasma.Over time they will change into steroid addict which is very difficult to manage.I usually stop steroid gradually using diluted steroid together using very mild soap and sometime I give antirosacea therapy.If we stop steroid immediatly ,the patient will have florid picture of dermatitis that need steroid.<br />khalifa sharquieAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9870114.post-85313583555898666262010-05-21T13:08:46.463+00:002010-05-21T13:08:46.463+00:00I have seen quite a number of cases with skin abus...I have seen quite a number of cases with skin abused by topical corticosteroids. The cutaneous manifestations have varied from predominant erythema (telangiectasia)only to florid rosacea-like picture with papules.Now there are 2 concerns here. One is why the patient started using the steroid in the first place; was it a steroid responsive dermatosis? Most of the times it has been difficult for me to arrive at an answer by clinical examination; the history suggests some kind of an itchy rash probably dermatitis (may have been photosensitive or not). The other issue is to advise and to make sure the patient stops using the steroid immediately; this is also not easy. Although I tend to prescribe tacrolimus/pimecrolimus for my patients along with emollients and a sunblock, however follow-ups have shown that the patient reverts to the steroid when he/she feels unsatisfied by my new line of management either because of initial aggravation of erythema or initial aggravation of pruritus or because of the patient's preconceived notions. Patients who do stick to not using the steroids do feel better after about 2-3 months; telangiectasia doesn't go completely. For a couple of my patients I tried Pulsed Dye Laser for persistent telangiectasia but response was not satisfactory for the patient and also objectively.<br />One concern haunts me whenever I see such a case. Should they be weaned off steroids immediately or gradually, as their skin has been 'addicted' to topical steroids very commonly for years? I do it immediately however for my patients.Ashok Kumar Sharmanoreply@blogger.com