Mechanisms of Action of Topical Corticosteroids in Psoriasis

Abstract

Psoriasis is a lifelong, chronic, and immune-mediated systemic disease, which affects approximately 1–3% of the Caucasian population. The different presentations of psoriasis require different approaches to treatment and appropriate prescriptions according to disease severity. The use of topical therapy remains a key component of the management of almost all psoriasis patients, and while mild disease is commonly treated only with topical agents, the use of topical therapy as adjuvant therapy in moderate-to-severe disease may also be helpful. This paper focuses on the cutaneous mechanisms of action of corticosteroids and on the currently available topical treatments, taking into account adverse effects, bioavailability, new combination treatments, and strategies to improve the safety of corticosteroids. It is established that the treatment choice should be tailored to match the individual patient's needs and his/her expectations, prescribing to each patient the most suitable vehicle.

Calcipotriol Plus Betamethasone Versus Betamethasone in Treatment of Scalp Psoriasis in an Iranian Population

“…Corticosteroid-induced skin atrophy is a consequence of collagen synthesis inhibition in connective tissue (18). Using low potency corticosteroids or their application in short periods of time may reduce the chance of permanent atrophy (17,21). Surprisingly, as opposed to the skinthinning effects of betamethasone, calcipotriol alone has been shown to cause skin thickening, thus skin atrophy would not be expected to occur with its use in combination with betamethasone (18,21).…”

Single-Dose of Submucosal Injection of Dexamethasone Affects the Post Operative Quality of Life After Third Molar Surgery

“…But reviewing various previous studies, the reason of rapid action that occurs in a few minutes as in this study could be due to nongenomic path of action by administering submucosal (tropical) injection of dexamethasone [10][11][12][13][14][15][16]. This pathway does not require de novo protein synthesis and acts by modulating the level of activation and responsiveness of target cells, such as monocytes, T cells, and platelets and also leads to peripheral vasoconstriction which further increases local drug concentrations [27].…”

Topical Steroid Induced Iatrogenic Cushing Syndrome in Young Adult Age Group: A Case Report

“…1,6,7 Although systemic side effects of topically applied corticosteroids are much more commonly noticedin children, this phenomenon has been described in adults several times. There is some evidence that these systemic side effects are dose-dependent.…”

“…However, over 75% of patients belong to a clear sub group that develops the disease before the age of 40 with reported prevalence ranging from 2% to 4.7%. [1][2][3] Psoriasisis characterized by round, erythematous, well-marginated plaques covered by characteristic grayish or silvery white scales with predilection on the scalp, elbows, knees and lumbosacral and anogenital regions. Many factors should be considered in choosing treatment for psoriasis.…”