Prevention and treatment of glucocorticoid-induced osteoporosis in daily dermatologic practice.
BACKGROUND
Systemic glucocorticoids (GCs) are often needed to treat dermatologic patients. The long-term use of GCs, however, is associated with potentially severe side-effects. GC-induced osteoporosis (GIO) is one of the most serious complications, but the risk of the occurrence of GIO seems to be generally underestimated.


OBJECTIVE
To provide an update of the recent advances in the prevention of GIO in dermatologic practice.


METHODS
Review of the literature and several European and US guidelines up to August 2007.


RESULTS
Data regarding the prevention and treatment of GIO are limited and guidelines for the prevention of GIO are not fully consistent.


CONCLUSIONS
The prophylaxis of osteoporosis needs to be started early during treatment with GCs. Calcium and vitamin D supplements in all patients on systemic GCs and bisphosphonates in patients who take GCs for more than 3 months are practical and effective measures.
Vermaat
Hester
H
Department of Dermatology, Vrije Universiteit Medical Center, Amsterdam, Netherlands. H.Vermaat@vumc.nl
Kirtschig
Gudula
G
D015519:Bone Density / Q000187:drug effects; D002118:Calcium / Q000627:therapeutic use; D003880:Dermatology / Q000379:methods; D004164:Diphosphonates / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000517:prevention & control*; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008134:Long-Term Care; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011859:Radiography; D018570:Risk Assessment; D012871:Skin Diseases / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use
D004164:Diphosphonates; D005938:Glucocorticoids; D014807:Vitamin D; D002118:Calcium