Hazards of steroid therapy in hepatic failure

Abstract

SUMMARY Three patients with extensive skin disease and liver failure are described. Two were treated with large amounts of topical corticosteroids and one with a small oral dose of betamethasone. The former two patients developed Addisonian crises when they failed to apply the topical steroids and all three patients developed aseptic necrosis of bone. This report emphasizes that the hazards of steroid therapy may be increased in patients with hepatic failure.

Osteonecrosis of the femoral head and glaucoma caused by topical corticosteroid application

“…However, this problem is usually associated with oral administration or IV injection, and it is quite rare with topical corticosteroid application. Several hips have been reported as showing ONFH following the use of topical corticosteroid ointments [4][5][6][7][8][9][10]; Cunliffe et al [4] first reported two cases of 2 hips in 1975. However, these reports included patients with a medical history of systemic corticosteroid therapy as well as topical corticosteroid treatment or a history of alcohol abuse.…”