Topical and Systemic Corticosteroids

Glucocorticoid-Induced Skin Atrophy: The Old and the New

“…Foams (which register higher patient compliance), gels and lotions are better suited for scalp psoriasis. 7,12 The adverse effects manifested in topical GC use also depend on the chemical structure of the therapeutic agent, as those with higher potency have a higher potential of producing side-effects such as skin atrophy. 13 The GC Receptor (GR) GC exert their actions by binding to their receptors -type I (mineralocorticoid receptor -MR) and type II (glucocorticoid receptor -GR), both intracellular nuclear receptors, transcription factors able to regulate gene expression.…”

“…The latter make these agents useful in treating inflammatory skin disorders such as allergic contact eczema, atopic hand eczema, nummular eczema, psoriasis vulgaris or toxicirritative eczema. 7,12,27 Unfortunately, as in the case of other unsupervised or irresponsible drug use, the long-term/chronic use of GC in dermatology has serious (permanent) side-effects, mainly of metabolic and atrophic nature, such as -osteonecrosis, Cushing syndrome, hypertension, corticodependence, tachyphylaxis, exacerbation of diabetes, skin atrophy (also found with the use of mometasone furoate), contact dermatitis, rosaceiform dermatitis, striae distensae, rubeosis, telangiectasia, purpura, stellate pseudoscars, ulceration, infections (secondary demodicosis), hypo-or hyperpigmentation, hirsutism or acne. Disease exacerbation can also take place when using other drugs in dermatology or other medical fields, such as beta-blockers or statins and hydrochlorothiazide.…”

“…5,6 Immune suppression and anti-inflammatory activities are two important properties of GC which make them useful in treating skin disorders (such as systemic lupus erythematosus, occupational skin diseases), rheumatoid arthritis, inflammatory bowel disease (ulcerative colitis), asthma, transplant rejection, age-related macular degeneration, multiple sclerosis, sarcoidosis, nephrotic syndrome or even lichen sclerosus (which is a sclerosing, atrophic disease with an inflammatory component). 1,2,[7][8][9][10][11] Considering the type of treatment administered (long or short term, local or systemic), GC can induce GC resistance and have many side-effects such as -increased infection risk, hyperglycemia/increased insulin resistance/ diabetes, osteoporosis, osteonecrosis, obesity, infection, hypertension, impaired wound healing, mental disturbances (mood disorders such as depression), or skin atrophy (which will be discussed in further detail). 1,2…”

“…Immune suppression and anti-inflammatory activities are two important properties of GC which make them useful in treating skin disorders (such as systemic lupus erythematosus, occupational skin diseases), rheumatoid arthritis, inflammatory bowel disease (ulcerative colitis), asthma, transplant rejection, age-related macular degeneration, multiple sclerosis, sarcoidosis, nephrotic syndrome or even lichen sclerosus (which is a sclerosing, atrophic disease with an inflammatory component). 1 , 2 , 7–11 …”

UPLC-ESI/MS/MS Profiling and Anti-Inflammatory Activity of Gleditsia caspica

“…Moreover, contact urticaria has been reported from oxyphenbutazone [33]. On the other hand, topical anti-inflammatory synthetic corticosteroids possess a variety of adverse effects such as skin atrophy and telangiectasia, that's why long-term use of topical steroids is limited [34]. Topical synthetic retinoids are a class of anti-inflammatory drugs used mainly in acne treatment and can lead to toxic contact dermatitis [35].…”