Adverse effect profile of long-term oral corticosteroid therapy in dermatology practice: Are we monitoring sufficiently?

Oral corticosteroids remain the most important agent in the management of immune-mediated skin disorders. However, their long-term use precipitates potentially serious adverse effects.

A cohort of 48 patients on long-term oral steroid therapy attending a special dermatology clinic were reviewed in relation to prevalence of adverse effects as well as pattern and frequency of monitoring required, basic clinical parameters, blood chemistry and other special investigations.

More than 50% had maintenance prednisolone requirements of over 10 mg/d. Over 60% reported dyspepsia and low back pain. Approximately 40% developed diabetes. Other endocrine abnormalities were detected in over 20%.

Monitoring frequency of body weight, blood pressure, plasma glucose and blood counts were satisfactory. Monitoring of Bone Mineral Density (BMD), lipids and electrolytes required further improvement.

In conclusion, a high prevalence of adverse effects associated with long-term oral corticosteroid therapy is seen in the cohort of patients studied. Close monitoring with a vigilant protocol is required for early detection and treatment of related complications.