[Glucocorticoid-induced cutaneous adverse events]

Glucocorticoids are largely used in therapy for many diseases with a noteworthy efficacy. However, the use of glucocorticoids by a systemic or local way (topical or inhaled) is associated with numerous cutaneous side effects. Long duration of treatment and high dosage are associated with more severe side effects. Complications are related to the pharmacological properties of the molecules, especially metabolic and immunosuppressive. Metabolic side effects are mainly skin atrophy: the skin is thin, with easy bleeding and superficial erosions. Other metabolic complications are striae, acne of papulo-pustular type, hypertrichosis, and delayed wound healing. Immunosuppressive side effects are mainly infections: mycoses (dermatophytosis), parasites (Norwegian scabies), bacterial or viral (especially with herpes virus) infections. Glucocorticoids promote opportunistic infections of the skin. Allergy to glucocorticoids is frequent but its diagnosis is uneasy. Clinical aspect is an eczematous eruption related to delayed hypersensitivity and etiological diagnosis is obtained by epicutaneous tests. A better knowledge of glucocorticoid-induced cutaneous side effects can allow to propose preventive measures and especially educational program for patients receiving long-term glucocorticoids for chronic diseases.