I use steroids as staph marginal is more of an inflammatory reaction to bacteria along the eyelids than an infiltrative lesion. Thus, treatment is geared at decreasing the bacterial load (lid scrubs, antibiotic drops) AND decreasing the inflammatory response (steroids).
Your gut reaction is a good one … as normally, steroids aren’t a good idea in the face of infection. I tend to watch larger lesions (like the one in this video) closely in case it turns into a full-blown ulcer. If so, then I stop the steroid, culture, and ramp up the antibiotic coverage.
Comment by admin — December 18, 2011