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Corticosteroids: adverse cutaneous effects,
even when inhaled

The adverse cutaneous effects of corticosteroids are not restricted to oral administration. The minimum effective dose of inhaled corticosteroids should be prescribed, especially in older patients.

Corticosteroids cause, among other things, adverse cutaneous effects: acne, ecchymosis, delayed healing, stretch marks, etc.

While these adverse effects are known to occur above all with orally administered corticosteroids, inhaled corticosteroids can also cause adverse cutaneous effects. A trial involving more than 1,000 patients monitored for between 3½ and 4½ years compared the use of an inhaled corticosteroid against placebo in subjects with chronic obstructive bronchopulmonary disease. Adverse cutaneous effects such as ecchymosis or delayed healing, affecting the entire body, occurred more frequently in patients receiving high doses of corticosteroids. The risk of these adverse cutaneous effects occurring appeared to be 4 times higher for patients aged 56 or over.

These data, which apply to all inhaled corticoids, confirm the existence of dose-dependent adverse cutaneous effects for inhaled corticosteroids, particularly in elderly patients. Therefore the minimum effective dose of any corticosteroid-based treatment, even inhaled, should be regularly reviewed.

©Prescrire January 2007

Source: "Effets indésirables cutanés des corticoïdes inhalés" Rev Prescrire 2007 ; 27 (279) : 25

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