Glucocorticoids are the first-line therapy for many dermatological diseases due to their anti-inflammatory and immunosuppressive activity as well as their rapid clinical response. Systemic corticosteroids (CSs) are usually administered orally but intravenous and intramuscular formulations are also available. The main differences among the CSs concern the duration of adrenocorticotropic hormone (ACTH) suppression, the anti-inflammatory activity, and the mineralocorticoid effect. Prednisolone is usually the molecule of choice because of its minimal mineralocorticoid activity and its duration of action that guarantees the effectiveness of the therapy with a single daily dose. The daily dose of CSs is usually administered in the morning at the peak of endogenous secretion of cortisol in order to minimize adverse effects. The main adverse effects related to CSs therapy are due to the alteration of the electrolyte balance, increased risk of infections, increased gluconeogenesis, inhibition of ACTH secretion, and risk of delayed growth in children. In conclusion, CSs constitute an important therapeutic option for many dermatological pathologies, even if not without adverse effects. Dermatologists should be aware of their therapeutic properties and their side effects to prevent serious complications.
Ekinde, S., Cambazard, F., Cinotti, E. (2023). Glucocorticoids: Systemic. In T.L. A. D. Katsambas (a cura di), European Handbook of Dermatological Treatment (pp. 1653-1659). Springer Cham [10.1007/978-3-031-15130-9_146].
Glucocorticoids: Systemic
Cinotti E.
2023-01-01
Abstract
Glucocorticoids are the first-line therapy for many dermatological diseases due to their anti-inflammatory and immunosuppressive activity as well as their rapid clinical response. Systemic corticosteroids (CSs) are usually administered orally but intravenous and intramuscular formulations are also available. The main differences among the CSs concern the duration of adrenocorticotropic hormone (ACTH) suppression, the anti-inflammatory activity, and the mineralocorticoid effect. Prednisolone is usually the molecule of choice because of its minimal mineralocorticoid activity and its duration of action that guarantees the effectiveness of the therapy with a single daily dose. The daily dose of CSs is usually administered in the morning at the peak of endogenous secretion of cortisol in order to minimize adverse effects. The main adverse effects related to CSs therapy are due to the alteration of the electrolyte balance, increased risk of infections, increased gluconeogenesis, inhibition of ACTH secretion, and risk of delayed growth in children. In conclusion, CSs constitute an important therapeutic option for many dermatological pathologies, even if not without adverse effects. Dermatologists should be aware of their therapeutic properties and their side effects to prevent serious complications.
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https://hdl.handle.net/11365/1278710