The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.
Subgroup analyses for causative organisms showed that corticosteroids reduced mortality in Streptococcus pneumoniae ( S. pneumoniae ) meningitis ( RR , 95% CI to ), but not in Haemophilus influenzae ( H. influenzae ) or Neisseria meningitidis ( N. meningitidis ) meningitis. Corticosteroids reduced severe hearing loss in children with H. influenzae meningitis ( RR , 95% CI to ) but not in children with meningitis due to non- Haemophilus species.
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