Glucocorticoid-induced skin atrophy consequence in surgery. a distal tibia fracture case

Glucocorticoids are largely used in therapy for many diseases with a noteworthy efficacy. However, the use of glucocorticoids by a systemic or local way (topical or inhaled) is associated with numerous cutaneous side effects. Long duration of treatment and high dosage are associated with more severe side effects. Complications are related to the pharmacological properties of the molecules, especially metabolic and immunosuppressive. The mainly metabolic side effect is skin atrophy. Surgery on such skin is fastidious with complications which can be tragic.We report a case of advanced glucocorticoid-induced skin atrophy that resulted in involuntary extension of skin incision for percutaneous plate with secondary skin and covering flap necrosis. Vacuum assisted closure and spontaneous healing lead to a satisfactory result.