title: Topical steroid abuse: its use as a depigmenting agent.
abstract: This study was undertaken to document prevalence, motives and observed complications of steroid use as a depigmenting agent amongst African blacks in southeast Nigeria. This practice is very common in the African environment. Consecutive new patients attending the dermatology clinic of the University of Nigeria TeachingHospital, Enugu, from June to December 2004 were recruited. Active substances of products used were determined from packages, while unknown concoctions were analyzed. Chi-squared and Fischer tests were used for statistical analysis, with a significant threshold fixed at 5%. Females aged 18-69 years accounted for 75% (414) of patients. Main topical steroids used by both women and men were class-1 steroids, and these were often compounded with other bleaching products. Median duration of usage was 9 years +/- 1.3. Disorders observed included steroid-induced acne (45.3%), macular hyperpigmentation of face (37.2%), mycoses (40.4%), striae (28.3%), telangiectasis (21.3%), hypertrichosis (13.9%) and diabetes mellitus (2.1%). Duration of utilization of these topical steroids was significantly associated with severe local and systemic consequences, while withdrawal of the offending steroids usually resulted in severe withdrawal dermatitis that was unpleasant to patients. This may suggest that discontinuation is impossible.
authors.affiliation: Subdepartment of Dermatology, College of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria. nkechi_nnoruka@yahoo.com
authors.forename: Edith
authors.initials: E
authors.lastname: Nnoruka
authors.forename: Obiefuna
authors.initials: O
authors.lastname: Okoye
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000633:toxicity*; D003358:Cosmetics / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D004366:Nonprescription Drugs / Q000633:toxicity; D012651:Self Medication / Q000009:adverse effects*; D012871:Skin Diseases / Q000139:chemically induced*; D012880:Skin Pigmentation / Q000187:drug effects*; D013256:Steroids / Q000633:toxicity*; D011795:Surveys and Questionnaires
chemical_list: D000893:Anti-Inflammatory Agents; D003358:Cosmetics; D004366:Nonprescription Drugs; D013256:Steroids