Side-effects of topical glucocorticosteroids- can they be avoided?
More details
Hide details
Katedra i Klinika Dermatologii, Wenerologii i Alergologii, Uniwersytet Medyczny, Wrocław, Polska
Beata Anna Jastrząb   

Katedra i Klinika Dermatologii, Wenerologii i Alergologii Uniwersytetu Medycznego we Wrocławiu, Polska
Med Og Nauk Zdr. 2020;26(2):97–101
Introduction and objective:
Nowadays, topical glucocorticosteroids are widely used not only by dermatologists. They exert their anti-inflammatory, immunosuppressive and antiproliferative effects through various mechanisms. The wide range of their uses and availability often do not go hand-in-hand with proper dosage, which may be associated with the number of local and systemic side-effects. This article contains basic information necessary for rational pharmacotherapy.

Review of the current state of knowledge:
The choice of the right drug preparation depends on many factors. The selection of strength of a topical corticosteroid depends on the type of skin lesions and the anatomical region of application. Currently on the pharmaceutical market, a variety of vehicles for topical steroids are available which exhibit different properties. The fingertip unit (FTU) allows determination of the appropriate amount of topical preparation applied to the skin. The addition of other substances can extend the spectrum of topical glucocorticosteroids. Adverse side-effects of topical glucocorticoids can be divided into local and systemic, with the latter occurring significantly less frequently. Many of these adverse effects can be prevented, provided that the principles of appropriate drug selection are observed, as well as the application scheme and consideration of factors affecting drug absorption.

Knowledge of the basic rules of safe topical glucocorticosteroids therapy is useful not only for dermatologists, but also for other specialists. It allows us to optimize treatment, while reducing the risk of adverse effects.

Taheri A, Cantrell J and Feldman SR. Tachyphylaxis to topical glucocor-ticoids; what is the evidence? Dermatology Online Journal. 2013; 19(7).
Żaba R, Mikołajczyk K. Miejscowe preparaty glikokortykosteroidowe – zasady racjonalnego stosowania. Przewodnik Lekarza/Guide for GPs. 2004; 7(6): 61–69.
Martin-Gorgojo A, Johansen J-D and Giménez-Arnau A. Corticoste-roids: Topical. In: A.D. Katsambas et al. (eds.), European Handbook of Der-matological Treatment. Springer 2015; 1433–1443.
Kaszuba A, Pastuszka M, Kaszuba A. Miejscowe glikokortykosteroidy w leczeniu chorób skóry – zalecane standardy postępowania. Forum Medycyny Rodzinnej: czasopismo Polskiego Towarzystwa Medycyny Rodzinnej. 2009; 1897–3590; t. 3, nr 5, s. 347–358.
Cisło M, Kozłowska A, Nockowski P. Zasady leczenia miejscowego. W: J Szepietowski, W Baran, Terapia w dermatologii. Wydawnictwo Lekarskie PZWL: Warszawa 2019; 17–26.
Mehta AB, Nadkarni NJ, Patil SP, Godse KV, Gautam M, Agarwal S. Topical corticosteroids in dermatology. Indian J Dermatol Venereol Leprol. 2016; 82: 371–8.
Reszke R, Szepietowski J. Specjalistyczne podłoża dermatologicznie w terapii skojarzonej przewlekłych dermatoz. Forum Derm. 2016; 2: 3, 97–101.
Jaworek A, Zalewski A, Wojas-Pelc A. Znaczenie miejscowych glikokortykosteroidów we współczesnym lecznictwie dermatologicznym. Cz. 2. Farmacja Współczesna. 2018; 11; 220–230.
Chu A. Chapter 4. Antibacterial/steroid combination therapy in infected eczema. Acta Dermato-Venereologica. 2008, 88 (216): 28–34.
Kim GK. The rationale behind topical vitamin d analogs in the treatment of psoriasis: where does topical calcitriol fit in? J Clin Aesthet Dermatol. 2010; 3(8): 46‐53.
Shibata M, Katsuyama M, Onodera T. i wsp. Glucocorticoids enhance Toll-like receptor 2 expression in human keratinocytes stimulated with Propionibacterium acnes or proinflammatory cytokines. J Invest Dermatol. 2009; 129 (20): 375–382.
Isogai R, Yamada H. Factors involved in the development of diaper-area granuloma of the aged. Journal of Dermatology. 2013; 40: 1038–1041.
Ingersoll Z, Garza-Chapa JI, Pham R, Malouf P, Susa J, Weis S. Recurrent Granuloma Gluteale Infantum Secondary to Fecal Overflow Incontinence. Case Rep Dermatol. 2018 May–Aug; 10(2): 203–207.
Vatti RR, Ali F, Teuber S, Chang C, Gershwin ME. Reakcje nadwrażliwości na kortykosteroidy. Dermatologia po Dyplomie. 2013; 4(5): 23–37.