Comparative study of adverse drug reactions of corticosteroids

Abstract

Background: In Dermatology, corticosteroids (CSs) are widely prescribed in either topical or systemic formulations in various potencies to tailor therapy according to severity of the underlying condition, area of involvement, and patient’s age. CSs, however, are associated with a number of serious adverse effects, particularly with long-term usage. Aims: To study the relationship of adverse drug reactions (ADR) of long-term glucocorticoids (GC) with age, sex, smoking, alcoholism, underlying dermatologic conditions and co-existing medical disorders. To study CSs in relation to musculoskeletal system, metabolic & blood sugar levels and eye complications. To compare the ADR in cases on Oral mini pulse therapy (OMP) and Daily glucocorticoid (DGC) therapy groups. Methods: This was a hospital based prospective study done on 130 patients on OMP or Daily glucocorticoid therapy for more than 1 month duration, over a period of 2 years. Results: Cushingoid features and weight gain were observed in both groups. Bone changes, diabetes mellitus and hypertension were seen in patients on DGC therapy. Bone changes were seen in 17 (18.88%), Steroid induced Diabetes Mellitus (SDM) in 27(30%), Hypertension in 12(13.3%), Lipid abnormalities (in the form of raised cholesterol and triglyceride levels) in 7 (7.77%), Cataract in 12(13.33%) and glaucoma was seen in 1(1.11%) out of 90 patients on Daily glucocorticoid therapy.1 patient each out of 40 in the OMP group developed cataract and hypertension. Conclusion: In conditions like vitiligo, alopecia areata and lichen planus particularly in children, it is preferable to give OMP. In pemphigus group of disorders while using daily GC therapy, continuous monitoring and ADR prevention measures should be considered for patient's benefit.