Glucocorticoids are widely used in the treatment of many diseases. They have multiple therapeutic applications mainly because of their anti-inflammatory, immunosuppressive and antiproliferative activity. Glucocorticoids are broadly used in the therapy of dermatological diseases. Various routes of glucocorticoids administration are known. In the treatment of skin disorders, glucocorticoids are often administered topically. It must be noted that glucocorticoid-induced complications may occur not only as a result of systemic treatment, but also topical application of glucocorticoids to the skin. Commonly reported cutaneous adverse effects resulting from glucocorticoid therapy include changes in facial appearance – rounded appearance of the face, redness, development of stretch marks, difficulty in wound healing, and easy bruising. It needs to be highlighted that glucocorticoids also affect metabolism, water and electrolyte balance, and bones. Therefore, in addition to dermatological disorders, they may also cause many other types of complications. As a result, a degree of caution is advised in the use of drugs of this class. In order to reduce the risk of adverse effects, glucocorticoids should be used at the smallest effective dose for the shortest possible time.
Alopecia areata is a disorder with an estimated lifetime risk of 1 to 2%. The prevalence is the highest in the age group of 10 to 25 years. The exact aetiopathogenesis of alopecia areata is not precisely known, however, some factors that seem to play an important role in the development of the condition include autoimmune processes, stress or genetic vulnerability. Also, alopecia areata often coexists with depressive or anxiety disorders. The clinical presentation of alopecia areata includes sharply demarcated patches of hair loss, though the skin remains otherwise unaffected by any pathological changes. The severity of the condition varies greatly, and symptoms may range from isolated areas of hair loss on the scalp to total hair loss of the scalp -or even total loss of body hair. The most important differential diagnosis to consider in patients with suspected alopecia areata is androgenetic alopecia, i.e. the most common form of hair loss. The course of alopecia areata remains difficult to predict. In the majority of cases, the hair grows back spontaneously, but relapses are common. Treatment involves a variety of drugs, mainly immunomodulatory agents -either the types generating an allergic reaction or producing immunosuppressive effects. There are, however, no established treatment regimens for alopecia areata. It is worthwhile to note that antidepressants and non-pharmacologic interventions such as psychotherapy are also frequently used for treatment. Patients with alopecia areata often experience an impaired quality of life secondary to the disease. This fact, combined with the potential contribution of stress to the development of the condition, seems important from the viewpoint of considering psychological support in this group of patients.
Glikokortykosteroidy (GKS) są powszechnie stosowane w leczeniu różnych chorób dzięki ich działaniu immunosupresyjnemu i przeciwzapalnemu. Dobrze poznany został ich wpływ na wystąpienie powikłań metabolicznych, zwiększenie ryzyka sercowo-naczyniowego czy zmian w wyglądzie zewnętrznym. Glikokortykosteroidy mogą jednak również prowadzić do różnych powikłań w zakresie funkcjonowania układu rozrodczego oraz zaburzać prawidłowy przebieg ciąży. Z drugiej strony należy też pamiętać, że GKS znajdują zastosowanie w zapobieganiu niektórym powikłaniom położniczym. Większość powikłań steroidoterapii wynika z wpływu glikokortykosteroidów na funkcjonowanie osi podwzgórze-przysadka-gonady. Do działań niepożądanych ze strony układu płciowego związanych z przyjmowaniem steroidoterapii należą: zaburzenia miesiączkowania, zaburzenia płodności, obniżenie libido, rozwój hirustyzmu i powikłania związane z ciążą, jak: zahamowanie wzrostu płodu, wtórna niedoczynność nadnerczy płodu czy rozwój stanu przedrzucawkowego u kobiety ciężarnej. GKS są jednocześnie stosowane w stymulacji dojrzewania płuc płodu przy zagrażającym porodzie przedwczesnym czy w zapobieganiu maskulinizacji zewnętrznych narządów płciowych przy ryzyku wystąpienia wrodzonego przerostu nadnerczy. Podczas doboru terapii należy pamiętać, że poszczególne stosowane w terapii glikokortykosteroidy różnią się między sobą profilem działania, w tym stopniem przechodzenia przez łożysko, co ma istotne następstwa kliniczne.
Glucocorticoids are widely used as anti-inflammatory, antiproliferative and immunosuppressive agents in many diseases. Their use is often long-term, which is associated with the risk of adverse effects from various systems. In this paper, we pay particular attention to the effects of steroid therapy on cardiovascular diseases as long-term steroid therapy increases the risk of cardiovascular death. The risk of complications depends on the dose and therapy duration. Complications may also occur when steroids are used locally. According to literature data, glucocorticoids may contribute to the development of hypertension, myocardial ischaemia, heart failure and, according to some studies, stroke. The use of steroid therapy can lead to the development of disorders that are part of the metabolic syndrome. The pathogenesis includes the effects of glucocorticoids on the renin-angiotensin-aldosterone system, the autonomic system, stimulation of the mineralocorticoid receptor, and effects on the synthesis of factors regulating the width of blood vessels. Other disorders that may develop in the course of this therapy include osteoporosis, myopathy, electrolyte and metabolic disorders. However, it is difficult to determine to what extent the complications are caused by the therapy itself and to what extent by the treated disease. It is also worth noting about the negative impact of anabolic steroids, the use of which is usually not a part of therapy.
Obesity, which is becoming a lifestyle disease, is a significant social problem due to its growing frequency and its complications, primarily cardiovascular diseases. The recommended conservative treatment of obesity, consisting in the use of a weight reduction diet and physical activity, is often not effective or the effect of these actions does not last long. Bariatric surgery is an emerging field of surgery that can be used to treat obesity in a selected group of patients. Different operative methods of bariatric procedures are available. They allow one to achieve a significant weight loss. However, their application requires proper preparation of the patient before surgery and changes in eating habits and often chronic use of dietary supplements after surgery. This method of treatment should be considered in patients in whom conservative treatment has not produced the desired effect. Bariatric treatments are aimed not only at achieving weight loss, but also at improving the course of diseases often coexisting with obesity, such as type 2 diabetes or hypertension.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.