We keep seeing this condition despite dermatologists
repeatedly warning of the dangers of using a fluorinated steroid cream on the
face for more than 7 days. This is steroid induced rosacea, in this case from
mometasone but any fluorinated topical steroid can do it. There is overgrowth
of a small mite called demodex in the skin which causes a generalised facial
papular, sometimes pustular rash with curious sparing around the vermillion lip
border. It really flares when the topical steroid is stopped but this has to be
done to cure it. Also add in an oral tetracycline such as doxycycline 50 mgs bd
and try some 2% sulfur in sorbolene cream bd topically. Within a week it will
be improving but it often needs a month of therapy to see it settled completely
without any scarring. The initial rash treated might have been seborrheic
dermatitis but if it recurs then use any sulfur in sorbolene cream left! 1%
hydrocortisone cream virtually never causes this condition.
