Skin diseases in which steroids are contraindicated

 

Steroids—especially topical corticosteroids—are commonly used to treat various skin conditions due to their anti-inflammatory effects. However, in some skin diseases, they are contraindicated or can worsen the condition. Here are several examples:

1. Fungal Infections (e.g., Tinea/Ringworm)

• Why contraindicated: Steroids can suppress local immune responses, allowing the fungal infection to spread and become more severe.

• Result: Leads to tinea incognito, a condition where the fungal infection becomes atypical in appearance due to steroid use.

2. Rosacea

• Why contraindicated: Steroids can initially improve redness but often worsen the condition long-term.

• Result: Can cause steroid-induced rosacea, worsening erythema and telangiectasia.

3. Perioral Dermatitis

• Why contraindicated: This condition is often triggered or exacerbated by topical steroids.

• Result: Leads to persistent papules and pustules around the mouth, often requiring discontinuation of steroids for resolution.

4. Viral Infections (e.g., Herpes Simplex, Molluscum Contagiosum)

• Why contraindicated: Steroids impair immune response, potentially worsening viral replication and spread.

• Result: Can cause severe outbreaks, e.g., eczema herpeticum in atopic dermatitis.

5. Scabies

• Why contraindicated: Steroids can mask symptoms, delay diagnosis, and promote mite proliferation.

• Result: Can lead to scabies incognito, a more widespread and atypical presentation.