Quality of life in patients with facial steroid dermatitis before and after treatment.

BACKGROUND

Improper long-term, even low-dose, topical corticosteroids, especially application to the face, could induce steroid dermatitis, which was refractory and detrimental to the quality of life.

OBJECTIVE

To evaluate the quality of life in patients with facial steroid dermatitis before and after the treatment of doxycycline and indomethacin plus support therapy.

STUDY DESIGN

A prospective study.

SETTING

Outpatients of the Department of dermatology, the Third Hospital of Hangzhou, from August 2, 2004, to April 20, 2005.

SUBJECTS

Fifty consecutive outpatients completed the treatment.

INTERVENTION

The intervention is doxycycline 10 mg twice a day and indomethacin 25 mg twice a day for 4 weeks, cetirizine or loratadine 10 mg daily if pruritic, topical white petroleum if feeling dry and wet dressing if burning and oedema, plus psychological support and health education.

MAIN OUTCOME MEASURE

The efficacy of the treatment was quantified using a 24-point steroid clinical score. The detriment of the quality of life was quantified using a 30-point Dermatology Life Quality Index.

RESULTS

The steroid dermatitis clinical score decreased significantly from 15.06 +/- 4.61 at baseline to 4.52 +/- 3.39 at 2 weeks after the end of treatment (week 6; P < 0.001). Twenty-one patients underwent a rebound phenomenon and the steroid dermatitis clinical score increased significantly from 13.71 +/- 4.33 at baseline (week 0) to 19.24 +/- 3.40 at 1 week after treatment (week 1; P < 0.001). Quality of life score decreased significantly from 13.76 +/- 7.68 at baseline to 3.44 +/- 2.57 at 2 weeks after the end of treatment (week 6; P < 0.001).

CONCLUSIONS

The quality of life was profoundly affected by facial steroid dermatitis. Doxycycline and indomethacin plus support therapy might be effective in patients with facial steroid dermatitis.