Which of the following is not a typical adverse reaction to topical corticosteroids (CS)?

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From the Guidelines

Flu-like symptoms are not a typical adverse reaction to topical corticosteroids. Topical corticosteroids are known to cause various cutaneous side effects, including skin atrophy, telangiectasia, hypopigmentation, focal hypertrichosis, acneiform eruptions, and striae, as reported in a 2023 study published in the Journal of the American Academy of Dermatology 1. The most common adverse effects of topical corticosteroids include:

  • Skin atrophy
  • Telangiectasia
  • Striae
  • Folliculitis
  • Purpura
  • Acneiform eruptions
  • Perioral dermatitis
  • Skin infections These effects are more pronounced in areas with thin skin, such as the face, genitals, and intertriginous areas, and can be exacerbated by prolonged use of high-potency formulations or occlusion 1. However, flu-like symptoms are not typically associated with the use of topical corticosteroids, and the other options listed, such as skin irritation, skin atrophy, and acneiform lesions, are all recognized adverse reactions to topical corticosteroids, as supported by the evidence from the 2023 study 1.

From the FDA Drug Label

ADVERSE REACTIONS (listed alphabetically, under each subsection) The following adverse reactions have been reported with prednisone or other corticosteroids: Allergic Reactions anaphylactoid or hypersensitivity reactions, anaphylaxis, angioedema Dermatologic acne, acneiform eruptions, allergic dermatitis, alopecia, angioedema, angioneurotic edema, atrophy and thinning of skin, dry scaly skin, ecchymoses and petechiae (bruising), erythema, facial edema, hirsutism, impaired wound healing, increased sweating, Karposi’s sarcoma, lupus erythematosus-like lesions, perineal irritation, purpura, rash, striae, subcutaneous fat atrophy, suppression of reactions to skin tests, striae, telangiectasis, thin fragile skin, thinning scalp hair, urticaria

The answer is a. Flu-like symptoms.

  • Flu-like symptoms are not listed as an adverse reaction to topical corticosteroids.
  • Skin irritation (b), Skin atrophy (c), and Acneiform lesions (d) are all listed as adverse reactions. 2

From the Research

Adverse Reactions to Topical Corticosteroids

The following are common adverse reactions to topical corticosteroids:

  • Skin atrophy [(3,4)]
  • Skin irritation 5
  • Acneiform lesions [(3,6)]

Not a Typical Adverse Reaction

Based on the provided evidence, flu-like symptoms are not typically associated with topical corticosteroids [no direct reference]. The other options, such as skin irritation, skin atrophy, and acneiform lesions, are all mentioned as potential adverse effects of topical corticosteroids in the studies [(3,4,5,6)]. Therefore, the correct answer is: a. Flu-like symptoms

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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