Conflict of Interest The authors have no conflict of interest to declare.
Systemic steroids in the treatment of psoriasis: what is fact, what is fiction?
Article first published online: 25 JUL 2012
© 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 27, Issue 8, pages 1022–1025, August 2013
How to Cite
Mrowietz, U. and Domm, S. (2013), Systemic steroids in the treatment of psoriasis: what is fact, what is fiction?. Journal of the European Academy of Dermatology and Venereology, 27: 1022–1025. doi: 10.1111/j.1468-3083.2012.04656.x
Funding sources None.
- Issue published online: 17 JUL 2013
- Article first published online: 25 JUL 2012
- Received: 11 May 2012; Accepted: 22 June 2012
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.
Conclusion A re-evaluation of the treatment of psoriasis and/or psoriatic arthritis with systemic steroids is necessary.