Update on systemic glucocorticosteroids in dermatology

Glucocorticosteroids (GCSs) are the most important group of systemic drugs in dermatology for managing inflammatory skin disorders. This article reviews clinical usage guidelines, pharmacology, and mechanisms of action of GCSs, with particular focus on adverse reactions to these agents. The functioning of the hypothalamic-pituitary-adrenal axis also is covered, with a discussion of ways to minimize its suppression when GCSs are used. Recommendations are made for laboratory and radiologic studies during therapy. Finally, essential nutritional and dietary preventive therapy is outlined, along with possible necessary medication management, and appropriate medical or surgical subspecialty consultations.