What is the cause of a post-steroidal rash, also known as a steroid (corticosteroid)-induced rash?

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Differential Diagnosis for Post Steroidal Rash

  • Single most likely diagnosis
    • Steroid withdrawal rash: This is the most likely diagnosis as it is a common side effect of stopping or reducing steroid use. The rash typically appears within days to weeks after discontinuing or tapering steroids.
  • Other Likely diagnoses
    • Allergic contact dermatitis: This could be a possible diagnosis if the patient has come into contact with an allergen or irritant after stopping steroid use.
    • Irritant contact dermatitis: Similar to allergic contact dermatitis, this could be a possible diagnosis if the patient has been exposed to an irritant.
    • Eczema (atopic dermatitis) flare: Steroid use can suppress eczema symptoms, and stopping steroids can lead to a flare-up.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Infection (e.g., cellulitis, abscess): It is crucial to rule out an underlying infection, especially if the rash is accompanied by signs of infection such as fever, redness, or swelling.
    • Vasculitis: This is a potentially life-threatening condition that requires prompt diagnosis and treatment.
  • Rare diagnoses
    • Cutaneous lymphoma: Although rare, cutaneous lymphoma can present with a rash, and a thorough evaluation is necessary to rule out this diagnosis.
    • Pustular psoriasis: This is a rare but potentially severe condition that can be triggered by steroid withdrawal.
    • Autoimmune disorders (e.g., lupus, rheumatoid arthritis): In rare cases, a post-steroidal rash could be a manifestation of an underlying autoimmune disorder.

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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