The pathogenesis of topical steroid acne

Abstract

The earliest event in the development of the acneform eruption induced by topical fluocinolone acetonide was focal degeneration of the follicular epithelium. The abscess resulting from the seepage of sebum into the dermis was sharply curtailed by the antiinflammatory activity of the steroid. Since corticosteroids are not comedogenic in the rabbit ear canal it is believed that the open and closed comedones which eventually appear in humans after topical or systemic corticosteroids arise by an indirect means, namely by 'priming' the follicular epithelium to a native comedogenic substance, sebum.