Rapaport M J, Rapaport V
UCLA Medical Center, Beverly Hills, California, USA.
J Am Acad Dermatol. 1999 Sep;41(3 Pt 1):435-42. doi: 10.1016/s0190-9622(99)70118-0.
A retrospective review of all eyelid dermatitis patients seen over an 18-year period revealed a large subgroup of patients who had, as the basis for their ongoing problem, an addiction to the use of topical or systemic corticosteroids. This group of 100 patients often sought many consultations with various physicians. Unrelenting eyelid or facial dermatitis often resulted in the use of increasing amounts of corticosteroids for longer periods of time. Soon the skin became addicted. Once the work-up ruled out other causes, the remedy for the problem was absolute total cessation of corticosteroid usage. This article describes the typical history of the problem, the evaluation of these patients, and the distinctive pattern of flaring erythema that ensued when the corticosteroids were ceased. We stress the absolute necessity of total cessation of corticosteroid use as the only treatment for corticosteroid addiction. We also demonstrate that no additional therapy or further consultations were necessary once remission was obtained after topical corticosteroid abuse was halted.
一项对18年间所有眼睑皮炎患者的回顾性研究发现，有很大一部分患者存在对局部或全身使用皮质类固醇成瘾的问题，这是他们持续存在问题的根源。这100名患者经常向不同医生寻求多次会诊。持续的眼睑或面部皮炎常常导致在更长时间内使用越来越多的皮质类固醇。很快皮肤就成瘾了。一旦检查排除了其他原因，解决这个问题的方法就是绝对完全停止使用皮质类固醇。本文描述了该问题的典型病史、对这些患者的评估，以及停用皮质类固醇后随之出现的明显红斑发作模式。我们强调绝对有必要完全停止使用皮质类固醇，这是治疗皮质类固醇成瘾的唯一方法。我们还证明，在停止局部皮质类固醇滥用后获得缓解后，无需额外治疗或进一步会诊。
