Steroid atrophy in Adult
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Synopsis

Steroid atrophy presents as thinning of the skin and results from exposure to corticosteroids. Generalized thinning can occur as the result of long-term oral or inhaled steroid use. Localized thinning occurs following the direct application of topical agents to the skin. Steroid atrophy can be seen as early as 1 week after starting superpotent topical steroids under occlusion and as soon as 2 weeks with less potent agents. Atrophied skin may also be found over areas where intralesional steroids have been injected. Rapidly growing adolescents are at high risk for developing these skin changes. Weight lifters commonly develop these lesions. Striae can also occur in thinned skin.
This condition is also observed with increased endogenous production of glucocorticoids, such as in Cushing disease.
This condition is also observed with increased endogenous production of glucocorticoids, such as in Cushing disease.
Codes
ICD10CM:
L90.9 – Atrophic disorder of skin, unspecified
SNOMEDCT:
79983002 – Steroid atrophy
L90.9 – Atrophic disorder of skin, unspecified
SNOMEDCT:
79983002 – Steroid atrophy
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Consider various possible causes (eg, pregnancy, weightlifting, rapid growth, topical or systemic steroids, recent marked weight gain).
- Steroid atrophy has none of the epidermal scaling seen in inflammatory diseases.
- Radiation-induced changes (radiation dermatitis)
- Chronic sun damage
- Burn scar (see scar)
- Lipoatrophy associated with insulin injections
- Morphea
- Lichen sclerosus
Best Tests
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Management Pearls
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Therapy
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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.
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References
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Last Updated:07/11/2017
Steroid atrophy in Adult
See also in: External and Internal Eye