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Corticosteroid skin atrophy: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Corticosteroid skin atrophy is one of the side effects of prolonged corticosteroid therapy, general or local. The degree of skin atrophy in these cases is different, up to the depletion of the entire skin, which looks old, easily traumatized. Focal skin atrophy develops due to the use of corticosteroid ointments, mainly in children and young women, as a rule, with improper, uncontrolled use of fluorine-containing ointments assigned for occlusive dressing.
Changes in the skin can seize the epidermis or dermis, more rarely - the subcutaneous tissue, mainly after injections of suspensions containing corticosteroids. Atrophy, mostly limited, often band-shaped, the skin in these areas is thinned, acquires a livid shade, especially if corticosteroids were used in dermatoses, in the symptomatic complex of which includes telangiectasia (rosacea). Cyanotic shade may be due to the anti-inflammatory action of fluoride. In addition, in the foci of atrophy, especially in the elderly, hemorrhages, purpura, and stellate pseudo-scars can be observed. Most often atrophies of this kind develop on the face, the inner thighs, in the folds of the skin, on the hands.
Pathomorphology of corticosteroid skin atrophy. Histological kartava is similar to that of other types of atrophy, the diagnosis is established based on the history. Usually one of the first signs reveals thinning of the zidermis with smoothed intergrowth outgrowths. In the papillate layer of the dermis, the fibers lie loose, the lumens of the superficially located vessels are noted. Atrophy of the mesh layer of the dermis is detected only in the long-term existing elements.
Histogenesis of corticosteroid skin atrophy. The mechanism of development of atrophic changes from the use of corticosteroids is not established. It indicates the inhibition of DNA synthesis. Suppression of the synthetic activity of fibroblasts, a negative effect on the fibrous structures and the main substance of connective tissue, vasoconstrictive affect, change in the function of tissue basophils. Along with a decrease in the synthesis of collagen, it is expected to accelerate its destruction.
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