Post-topical steroid hypopigmentation

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The hypothesized etiology of hypopigmentation with corticosteroids relates to decreased melanocyte function. Friedman et al obtained a biopsy from a streak-like hypopigmented lesion in a young woman who had received four intralesional injections for keloids on her calf. Silver nitrate staining showed reduced melanin staining suggesting a reduced number or activity of the melanocytes [ 7 ]. Venkatesan and Fangman in 2009 performed Fontana-Masson staining and MART-1 staining on a punch biopsy specimen of a patient with right wrist hypopigmentation following intra-articular triamcinolone acetonide injections for de Quervain tendonitis. There was a decrease in pigment noted with Fontana-Masson staining, although intact melanocytes were noted along the dermal-epidermal junction, suggesting that melanocyte function may be impacted without the actual loss of melanocytes [ 11 ].

A common mistake is to be too cautious about topical steroids. Some parents undertreat their children's eczema because of an unfounded fear of topical steroids. They may not apply the steroid as often as prescribed, or at the strength needed to clear the flare-up. This may actually lead to using more steroid in the long term, as the inflamed skin may never completely clear. So, you may end up applying a topical steroid on and off (perhaps every few days) for quite some time. The child may be distressed or uncomfortable for this period if the inflammation does not clear properly. A flare-up is more likely to clear fully if topical steroids are used correctly.

Post-topical steroid hypopigmentation

post-topical steroid hypopigmentation

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