What are the side effects of long-term use of corticosteroids in the treatment of allergic contact dermatitis?

Updated: Aug 20, 2020
  • Author: Thomas N Helm, MD; Chief Editor: William D James, MD  more...
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Answer

Long-term use of systemic corticosteroids to treat allergic contact dermatitis may produce severe morbidity. Individuals with allergic contact dermatitis should not receive long-term systemic corticosteroids or immunosuppressives unless extensive patch testing and evaluation have failed to identify remedial causes of the severe dermatitis.

Long-term widespread use of potent topical corticosteroids may produce local skin atrophy and systemic adverse effects. In particular, use around the eyes may theoretically cause cataracts, glaucoma, corneal thinning/perforation, and loss of the eye.

Allergy to corticosteroid molecules without C16-methyl substitution in the D-ring (ie, groups A [eg, hydrocortisone, hydrocortisone-21-butyrate] and D2 [eg, hydrocortisone-17-butyrate] may be much more frequently observed than allergy to those corticosteroid molecules that are halogenated and have a methyl group at C16 (ie, groups D1 [eg, betamethasone dipropionate, clobetasol propionate, diflorasone diacetate, fluticasone propionate, mometasone furoate] and C [eg, desoximetasone, desoxymethasone]). [30] C16-methylated corticosteroids should be preferentially prescribed if topical corticosteroid treatment is indicated.


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