Steroid acne most often affects adolescent or adult patients who have been taking moderate or high doses of oral steroids such as prednisone or dexamethasone for several weeks. They can have a variety of underlying medical conditions.
Clinical features of steroid acne
Steroid acne most often occurs on the chest but may also develop on the face, neck, back and arms.
The steroids may aggravate a prior tendency to acne. It may affect any site prone to acne (eg face). The lesions tend to be more uniform in appearance than is usual with acne.
Steroid-induced acne vulgaris
In many patients, steroid acne is the same condition as malassezia folliculitis. It is due to proliferation of malassezia yeasts (also known as pityrosporum). It presents with itchy superficial papules and pustules on the chest and back.
In malassezia folliculitis, unlike acne vulgaris, most of the lesions are the same size. Comedones are not usually seen.