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Systemic disease and the skin
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
Acne papules occur on the chest, back, and face in most patients with Cushing’s syndrome. Steroid acne lesions are more uniform in appearance than adolescent acne and consist predominantly of small papules with few comedones. This type of acne is more resistant to treatment than ordinary acne.
Systemic disease and the skin
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
Acne papules occur on the chest, back and face in most patients with Cushing’s syndrome. Steroid acne lesions are more uniform in appearance than adolescent acne and consist predominantly of small papules with few comedones. This type of acne is more resistant to treatment than ordinary acne.
The professional sector
Published in Miho Ushiyama, Incorporating Patient Knowledge in Japan and the UK, 2019
Side effects are a concern, but are seen as manageable: In terms of systemic side effects, some studies report that applying strong topical steroids can suppress adrenal function in some cases, but there will be no suppression of adrenal function or growth failure with milder topical steroids. If topical steroids are applied appropriately, there will be few systemic side effects and their safety level is high. In terms of local side effects, atrophy of the skin, capillary dilatation, steroid acne, steroid rosacea, hair growth, stretch marks, and bacterial/fungal/viral skin infections may occur, but discontinuing use and applying other suitable measures will resolve basically everything but stretch marks.(Katō et al., 2016: 129)
Investigational drugs for atopic dermatitis
Published in Expert Opinion on Investigational Drugs, 2018
Kam Lun Hon, Alexander K.C. Leung, Theresa N. H. Leung, Vivian W. Y. Lee
Successful treatment of AD requires a systematic multipronged approach that consists of avoidance of triggering factors, optimal skin care, pharmacotherapy during acute exacerbations, and education of patients/caregivers [1,8]. Topical corticosteroids are the mainstay of pharmacotherapy for AD, with the choice of potency depending on the severity, site, and extent of the outbreak [8]. Corticosteroids mediate their anti-inflammatory effects through binding to a cytoplasmic glucocorticoid receptor in the target cells and forming complexes that enter the nucleus of the cell. The risk of side effects depends on the potency of the corticosteroid, concomitant use of occlusion, the area being covered, skin integrity, and duration of treatment. Compared with adults, children are at higher risk of both local and systemic effects. Local adverse effects particularly on delicate skin areas include skin atrophy, striae, depigmentation, telangiectasia, decreased subcutaneous adipose tissue, rosacea, perioral dermatitis, folliculitis, and steroid acne. Among systemic side effects are Cushing’s syndrome, adrenal suppression, cataracts, glaucoma, osteopenia/osteoporosis, and growth retardation. Rebound flares may occur following discontinuation of therapy. Tachyphylaxis may occur with prolonged treatment [36,37]. There is scanty evidence that growth retardation can also occur from inadequate control of severe eczema [38]. A new autosomal recessive entity has also been reported that severe pre- and postnatal growth retardation and developmental delay is associated with eczema [36-39]. Meanwhile, appropriate usage of topical corticosteroids for AD has been demonstrated to be associated with therapeutic efficacy without any adverse effects [40].