Complications of uncontrolled use of topical and systemic glucocorticosteroids: clinical cases

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Background. Glucocorticosteroids (GCS) have been successfully used since the discovery of hydrocortisone and remain the most commonly used group of drugs included in the treatment plans of patients with skin pathology. This is attributable to their ability to effectively influence both the pathogenetic mechanisms and the symptoms of skin diseases. For the effective and safe use of topical and systemic corticosteroids, it is necessary to comply with the indications and rules for their use. However, cases of irrational prescription or uncontrolled use of GCS are not uncommon, which significantly increases the risk of developing local and systemic side effects.

Description of a series of clinical cases. The article presents clinical observations of severe side effects of long-term self-treatment with systemic and topical corticosteroids that developed in patients aged 66 and 56 years. Long-term irrational topical use of betamethasone dipropionate by one of the patients and the use of 2.0 ml of corticosteroids for injection by another – a combination of the depot form (betamethasone sodium phosphate 2.63 mg) and the fast-acting form (betamethasone dipropionate 6.43 mg) – led to the formation of exogenous Cushing’s syndrome, infectious and other complications.

Conclusion. Violation of the rules for the use of GCS, as well as self-medication, lead to a high risk of developing both local and general side effects.

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作者简介

О. Nemchaninova

Novosibirsk State Medical University

Email: obnemchaninova@mail.ru
ORCID iD: 0000-0002-5961-6980
俄罗斯联邦, Novosibirsk

Tatyana Reshetnikova

Novosibirsk State Medical University

编辑信件的主要联系方式.
Email: obnemchaninova@mail.ru
ORCID iD: 0000-0002-6156-0875

Dr. Sci. (Med.), Professor, Department of Dermatovenereology and Cosmetology

俄罗斯联邦, Novosibirsk

O. Pozdnyakova

Novosibirsk State Medical University

Email: obnemchaninova@mail.ru
ORCID iD: 0000-0003-1389-1001
俄罗斯联邦, Novosibirsk

R. German

Novosibirsk State Medical University

Email: obnemchaninova@mail.ru
ORCID iD: 0009-0008-0462-8109
俄罗斯联邦, Novosibirsk

参考

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2. Fig.1. Thinning, vascular pattern and purpuric rashes on the skin of the chest (O.B. Nemchaninova et al., 2023)

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3. Fig.2. Erythema with a purplish tint in the area of inframammary folds, skin vessels and multiple small pustules are visualized (O.B. Nemchaninova et al., 2023)

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4. Fig.3. Thinning of the skin in the suprapubic fold, stretch marks, hemorrhages (O.B. Nemchaninova et al., 2023)

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5. Fig.4. Erythema of the skin of the inguinal folds, increased vascular pattern, hemorrhages and superficial erosions with a whitish coating, clinically characteristic of candida mycotic infection (O.B. Nemchaninova et al., 2023)

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6. Fig.5. Generalized dryness and flaking of the skin (O.B. Nemchaninova et al., 2023)

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7. Fig.6. Lower extremities: dryness, peeling and thinning of the skin, areas of scar atrophy, well-visualized superficial vessels (O.B. Nemchaninova et al., 2023)

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8. Fig.7. Upper extremities: dryness, peeling and thinning of the skin, areas of scar atrophy, well-visualized superficial vessels (O.B. Nemchaninova et al., 2023)

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9. Fig.8. Emphasis of the follicular apparatus, pustular elements at various stages of development (O.B. Nemchaninova et al., 2023)

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10. Fig.9. Multiple telangiectasias on the facial skin (O.B. Nemchaninova et al., 2023)

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11. Fig. 10. Multiple telangiectasias on the right cheek (O.B. Nemchaninova et al., 2023)

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