Abstract

In Dermatology, corticosteroids (CSs) are widely prescribed in various formulations to tailor the therapy according to severity of the condition, area of involvement, and patient’s age. CSs, are associated with a number of serious adverse effects, particularly with long-term use. 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 them in relation to the musculoskeletal system, metabolic *** levels and eye. Material and Methods: This was a prospective study done on 130 patients on glucocorticoid therapy for more than 1 month duration during a period of 2 years in the department of dermatology over a tertiary care centre. Thorough clinical examination, and relevant investigations were done. Results: Cushingoid features and weight gain were observed in both groups. Bone changes, DM and HT (Hypertension) were seen in patients on DGC therapy. Bone changes (in form of osteopenia, osteoporosis and AVN-avascular necrosis) were seen in 17 (18.88%), Steroid induced Diabetes Mellitus (SDM) in 27 (30%), HT 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 out of 40 in the OMP group developed cataract and HT. Maximum patients were in the age group of 31-40 years. Cushingoid features were observed in both groups.In the DGC group, Weight gain (82.22%), Bone changes 17(18.88%),Steroid induced Diabetes Mellitus 27 (30%),hypertension 12(13.3%),altered lipid profile 7(7.77%),Cataract in12 (13.33%) and glaucoma 1 (1.11%) were the side effects. Weight gain 10(25%) 1(2.5.% Hypertension and 1 (2.5.% ) developed cataract. 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. Females and elderly patients are at the risk of bone related side effects particularly due to long term usage of daily glucocorticosteroids. OMP , Pulse Therapy and other steroid sparing agents can be considered to prevent the side effects of long term GC therapy.

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