Elocon Skin Discoloration - Face

To begin with, I am 23, a lymphoma patient in remission for 12 months. I ended treatment in April of this year. If it is relevant to the issue of skin thinning: I was given high doses of dexamethasone and prednisone for the duration of my treatment, which lasted 9 months.

Three months after finishing Chemotherapy, in July of this year, I developed a bad case of what was later diagnosed by my dermatologist as contact dermatitis not only around my nostrils spreading onto my cheeks but extending all over my nostrils as well. This was deemed to be caused by a particular hair gel I began using after my hair regrew after finishing chemotherapy. I was studying in England at the time the rash broke out, and saw a London GP who prescribed Elocon ointment and told me to apply it to the affected area. I only applied Elocon twice and very sparingly. The flaking and redness stopped almost immediately after applying Elocon. However, afterwards I noticed that the skin where I applied the ointment was extremely light (I am dark skinned) and parts of my nostrils were purple and very shiny in texture. Since then, this has improved somewhat but my nostrils and the skin around my nostrils continues to be a light shade of purple as well as shiny as compared to the rest of my skin. I have noticed that this is improving, albeit very slowly. The affected area is not flaking, but the texture when felt by a finger is rougher than it should be. Also, the skin becomes extremely pink/red and looks shiny and almost plastic in texture when I flare my nostrils.

First, is this is a case of skin thinning (especially given my previous intake of dexamethasone and prednisone) and is this reversible?

Second, will the purple discoloration fade with time?

Third, is it possible that this is seborrheic dermatitis, even though the skin is not flaking and the dermatitis immediately eased up after I discontinued use of the hair gel?

At this point, I am only washing my face with Cetaphil.

Thank you.

[Alan Rockoff, MD]

As best I can tell without seeing you, I do not think you have skin thinning (Elocon is too weak to cause thinning), but rather post-inflammatory underpigmentaion.  Most likely you had seborrheic dermatitis, gone for now, but it will take some time for the color to return to normal, probably several months.  You should check this with a doctor in person when you can.  Meantime, Cetaphil is fine.

Take care.

Dr. Rockoff