ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferencesView all Images (53)
Steroid acne in Adult
Print
Other Resources UpToDate PubMed

Steroid acne in Adult

Print Images (53)
Contributors: Janelle S. Nassim MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Steroid acne is a form of acne resulting from the use of topical, oral, or even inhaled corticosteroids.

The pathogenesis of steroid acne is not fully understood. The induction of infundibular hyperkeratosis leading to microcomedo formation and subsequent follicular rupture have been implicated in the development of the papules and papulopustules in steroid acne. Glucocorticoids have been noted to enhance toll-like receptor 2 (TLR2) expression in human keratinocytes that is further stimulated by Propionibacterium acnes and other proinflammatory cytokines. This supports the notion that the presence of corticosteroids likely exacerbates existing acne and also can induce an acneiform eruption independently.

Susceptible individuals will experience the sudden onset of follicular papules and pustules approximately 2-5 weeks after starting the medication. The lesions of steroid acne, unlike acne vulgaris, are often of uniform size and symmetric distribution. The chest and back are sites of predilection after systemic steroid use. Steroid acne does not usually leave scars and clears with discontinuation of the inciting medication.

Predisposing factors to topical steroid-induced acne that have been reported include higher concentration, application under occlusion, and application to inherently acne-prone areas of face and upper part of the back. Additionally, young adults may have a higher incidence. It is less likely to occur before puberty or in geriatric patients.

Other medications commonly associated with acneiform eruptions include anabolic steroids, phenytoin, lithium, isoniazid, halogenated compounds, epidermal growth factor receptor inhibitors, and immune checkpoint inhibitors.

Codes

ICD10CM:
L70.8 – Other acne

SNOMEDCT:
201222006 – Steroid acne

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Reviewed: 11/30/2018
Last Updated: 12/19/2018
Copyright © 2019 VisualDx®. All rights reserved.
Steroid acne in Adult
Print 53 Images Filter Images
View all Images (53)
(with subscription)
 Reset
Steroid acne : Face, Pustule, Superior chest, Upper back
Clinical image of Steroid acne
Copyright © 2019 VisualDx®. All rights reserved.