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Prevention and treatment of glucocorticoid-induced osteoporosis in daily dermatologic practice


Hester Vermaat, MD Department of Dermatology Vrije Universiteit Medical Center De Boelelaan 1117 1007 MB Amsterdam Netherlands


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.

Aim  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.

Conclusion  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.