drug adverse effects of topical glucocorticoids
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Adverse effects
- common*
- less common
- hypertrichosis
- pigmentation alterations
- delayed wound healing
- exacerbation of skin infections
- other
- contact sensitization
- systemic reactions within chronic use of potent agents[2][6]
- hyperglycemia
- systemic absorption may increase risk of type 2 diabetes[11]
- glaucoma
- cataracts[7][8]
- adrenal insufficiency
- high doses of potent glucocorticoid during pregnancy may result in low birth weight infant[4]
- potent topical glucocorticoids associated with increased risk for osteoporosis & major fracture (< 122/10,000 patient years)[12]
- hyperglycemia
* adverse effects more common when applied to areas of occlusion by clothing or skin folds[2]
Management
- do not use potent of fluorinated glucocorticoids on face
- try to limit use to one week; if longer therapy is needed try pulse therapy, 1 week of therapy, 1-3 weeks off
More general terms
References
- ↑ Prescriber's Letter 16(12): 2009 Comparison of Topical Corticosteroids Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=251227&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 2.0 2.1 2.2 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018.
- ↑ Prescriber's Letter 18(10): 2011 Hyperglycemia Associated with Non-oral and Locally Injected Corticosteroids Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=271022&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 4.0 4.1 Chi CC et al Pregnancy Outcomes After Maternal Exposure to Topical Corticosteroids. A UK Population-Based Cohort Study. JAMA Dermatol. Published online September 04, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24005903 <Internet> http://archderm.jamanetwork.com/article.aspx?articleid=1735120
- ↑ Del Rosso J, Friedlander SF. Corticosteroids: options in the era of steroid-sparing therapy. J Am Acad Dermatol. 2005 Jul;53(1 Suppl 1):S50-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15968264
- ↑ 6.0 6.1 Hengge UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006 Jan;54(1):1-15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16384751
- ↑ 7.0 7.1 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
- ↑ 8.0 8.1 Haeck IM, Rouwen TJ, Timmer-de Mik L Topical corticosteroids in atopic dermatitis and the risk of glaucoma and cataracts. J Am Acad Dermatol. 2011 Feb;64(2):275-81
- ↑ Beer K, Downie J. Sequelae from inadvertent long-term use of potent topical steroids. J Drugs Dermatol. 2007 May;6(5):550-1 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17679193
- ↑ Barnes L, Kaya G, Rollason V. Topical corticosteroid-induced skin atrophy: a comprehensive review. Drug Saf. 2015 May;38(5):493-509. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25862024
- ↑ 11.0 11.1 Andersen YMF, Egeberg A, Ban L et al. Association between topical corticosteroid use and type 2 diabetes in two European population-based adult cohorts. Diabetes Care 2019 Jun; 42:1095 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30936111 <Internet> http://care.diabetesjournals.org/content/42/6/1095
- ↑ 12.0 12.1 Egeberg A, Schwarz P, Harslof T et al Association of Potent and Very Potent Topical Corticosteroids and the Risk of Osteoporosis and Major Osteoporotic Fractures. JAMA Dermatol. Published online January 20, 2021. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33471030 https://jamanetwork.com/journals/jamadermatology/article-abstract/2775153
Jackson RD Topical Corticosteroids and Glucocorticoid-Induced Osteoporosis - Cumulative Dose and Duration Matter. JAMA Dermatol. Published online January 20, 2021 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33471024 https://jamanetwork.com/journals/jamadermatology/article-abstract/2775150