Cutaneous side effects of oral corticosteroid therapy

Background Corticosteroids revolutionized the treatment of many skin disorders during 5th and 6th decades of last century. They have anti inflammatory, vasoconstrictor, antiproliferative and immunosuppressive effects. Objective The study was aimed to determine the frequency of cutaneous changes in patients on oral steroids and to see the pattern of these changes in our population. Material and methods The study was carried out in the department of dermatology, Civil Hospital, Karachi. 204 patients fulfilling the inclusion criteria completed in the study. All the patients were taking 60-80mg of oral steroids for a minimum of 2 weeks. Findings were recorded on a preformed pro forma. Any relevant investigations were also carried out. Results were then compiled and tabulated. Results Multiple cutaneous infections was the most common side effect seen in 45 patients (22%, p 0.10). Moon face was seen in 39 patients (19%, p 0.001) and buffalo hump in 17 patients (8.3%, p 0.08). Atrophic changes were a feature in 45 patients (22.5%, p 0.47). Other findings seen in our patients were acneiform eruptions in 18 patients (8.7%, p 0.001) and hypertrichosis in 8 patients (4%, p 0.013). Conclusion Oral steroid therapy is associated with significant cutaneous side effects which depend on the dose and duration of therapy. Bacterial infections remain the most common side effect