Years of topical steriod from alot of different drCreated by:
Saw this patient today and I thought of sharing a case with fellow colleagues. This is not my patient but someone who came to my clinic requesting for topical elomet cream because she has intense itch over the neck, face and bilateral forearm. She is an elderly Chinese about 65 year old. She brought with her alot of cream - gentriderm, neoderm, betamethasone 0.1% , elomet cream etc. She claimed to be using all these creams for the last few years for itch . I have atteched 2 photos here taken with her consent. On areas of prurigo, she has echymoses, telangiectasia, skin atrophy and multiple pustules ( neck ). I diagnosed her with skin atrophy due to chronic topical steriod usage. Of concern are the pustules on her neck. I am treating her for staph folliculitis due to chronic topical steriod. She was started on topical fusidic acid and oral cloxacillin. It may well turn out to be candida pustules. Reviewing her in 1 week. Any colleague has got any advice?