Suggested rationale for prevention and treatment of glucocorticoid-inducedbone loss in dermatologic patients

Glucocorticoid-induced bone loss is the most predictable and debilitating c omplication of prolonged administration of systemic corticosteroids. It has been shown that patients treated with glucocorticoids have an increased ri sk of osteoporotic fractures, resulting in marked morbidity, particularly i n elderly individuals. Studies on the effect of glucocorticoids on bone den sity and the efficacy of treatment regimens (namely, bisphosphonates and ca lcitonin) for preventing bone loss have been mainly on patients with asthma and rheumatologic diseases. However, no long-term studies have been done o n the impact of prolonged corticosteroid treatment in dermatologic patients . The purpose of this review is to raise awareness about osteoporosis and n ew preventive measures among the dermatologists treating patients with gluc ocorticoids at high doses and for long periods. We summarize the assessment methods used to evaluate this condition, examine the results of clinical t rials of drugs, and suggest a practical approach to managing corticosteroid osteoporosis in dermatologic patients based on data collected from publish ed articles.