title: Systemic steroids in the treatment of psoriasis: what is fact, what is fiction?
abstract: BACKGROUND
  The use of systemic steroids in the treatment of psoriasis is not recommended by dermatological textbooks and guidelines because of the risk of disease deterioration after dose reduction or withdrawal. In contrast to these recommendations, a recent analysis using data from a German nationwide healthcare insurance revealed that systemic steroids were the most frequently prescribed drugs for psoriasis by general practitioners, internal medicine physicians and dermatologists.
  
  
  OBJECTIVE
  As there is an obvious discrepancy between the use of systemic steroids for psoriasis and the reported adverse effects, a non-systematic literature search starting 1950 until today was performed to address beneficial and adverse effect of systemic steroids in psoriasis.
  
  
  METHODS
  Non-systematic literature search.
  
  
  RESULTS
  Regarding the widespread use of systemic steroids in psoriasis and other medical conditions taking the high prevalence of psoriasis of 2-3% at least in Caucasians into consideration, there is a remarkable lack of literature addressing adverse effects such as rebound, pustular or erythrodermic flares or even new occurrence of psoriasis in patients with a negative disease history.
  
  
  CONCLUSIONS
  A re-evaluation of the treatment of psoriasis and/or psoriatic arthritis with systemic steroids is necessary.
authors: Psoriasis Center at Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany. umrowietz@dermatology.uni-kiel.de
authors: U
authors: U
authors: Mrowietz
authors: S
authors: S
authors: Domm
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy*
chemical_list: D000305:Adrenal Cortex Hormones