Topical corticosteroids play a key role in the treatment of hyper-granulating wounds (Figure 3). They reduce exuberant granulation tissue and its epidermalization, which is otherwise impossible for mechanical reasons. Although often feared by practitioners, they do not cause infectious complications in chronic wounds and can be a valuable aid.
They do delay healing, unlike systemic corticosteroids.
However, at high doses and with prolonged use (e.g. in the treatment of autoimmune bullous dermatoses), they can cause skin atrophy, resulting in skin tears at the slightest trauma.
Figure 3. Hyper-granulation ulcer requiring the application of topical corticosteroids.
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