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Rebounding triad (severe itching, dryness and burning) after facial corticosteroid discontinuation defines a specific class of corticosteroid‐dependent dermatitis
Author(s) -
Xiao Xiao,
Xie Hongfu,
Jian Dan,
Deng Yuxuan,
Chen Xiang,
Li Ji
Publication year - 2015
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.12877
Subject(s) - medicine , discontinuation , corticosteroid , itching , odds ratio , confidence interval , dermatology , surgery
In patients with dermatitis, the sudden discontinuation of topical corticosteroid ( TC ) use after long‐term treatment could cause flaring symptoms (named “rebounding responses”). Diagnostic criteria for facial corticosteroid‐dependent dermatitis ( FCDD ) are vague and uncertain. We aim to define a category of patients with clinical rebounding triad including severe itching, dryness and burning. Patients with FCDD ( n = 268) were evaluated to determine distinctive rebounding triad manifestations after TC cessation. Data on history of facial TC use and rebounding presentations were collected. A group of chronic dermatitis patients ( n = 83) with rebounding triad after TC discontinuation were enrolled and added to patients with FCDD presenting triad symptoms. Patients without triad were compared with triad‐positive patients. Eighty‐five patients who displayed triad manifestations after TC cessation showed longer (93.1 ± 53.6 vs 9.6 ± 5.5 weeks, P < 0.001) and more frequent (7.7 ± 4.5 vs 2.3 ± 1.6 times/week, P < 0.001) use of TC . Similar results were observed after adding 83 dermatitis patients who experienced triad after TC cessation. Multivariate analysis showed that mean duration of TC use (odds ratio [ OR ] = 1.83, 95% confidence interval (95% CI ) = 1.042–3.218, P = 0.035) and mean frequency of TC use ( OR = 2.802, 95% CI = 1.135–6.918, P = 0.025) were independent predictors of rebounding triad after TC cessation. Duration and frequency of TC use were the main factors predicting rebounding triad.