|
| Fig. 50.3 Cutaneous atrophy and slight hypopigmentation from intralesional corticosteroids. (Courtesy of the Fitzsimons Army Medical Center teaching files.) |
|
| Fig. 50.4 Striae associated with midpotency topical steroid use. |
Within 1 to 3 weeks of using superpotent topical steroids, the dermal volume is measurably reduced. This is due to decreased fibroblast production of dermal ground substance, primarily hyaluronic acid, and decreased dermal water content. Abnormal synthesis of collagen and elastin results in dermal atrophy (Fig. 50-3), skin fragility, striae (Fig. 50-4), telangiectasias, poor vascular support with skin purpura, and decreased wound healing.
