Khan Yulia K, Kalaaji Amer N, Clarke Bart L
Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
J Drugs Dermatol. 2008 Nov;7(11):1053-9.
Systemic glucocorticoids are widely used in dermatologic practice for various conditions including connective tissue and immunobullous diseases, vasculitis, dermatitis, neutrophilic and other dermatoses, and androgen excess syndromes. Long-term use of systemic glucocorticoids has been associated with substantial and rapid bone loss, which places patients at increased risk for bone fractures. Therefore, bone density measurements and the timely initiation of lifestyle modifications and pharmacotherapy are essential for future bone health. The use of several Food and Drug Administration-approved agents to prevent and treat corticosteroid-induced bone loss has been inconsistent among many specialties. In this review, the authors summarize guidelines on the prevention and treatment of corticosteroid-induced bone loss published by the American College of Rheumatology and supplement these guidelines with descriptions of the latest approved pharmacologic therapies and user-friendly flow algorithms. This summary should aid dermatologists in providing education and recommendations regarding bone health for their patients on systemic glucocorticoids.
全身性糖皮质激素在皮肤科临床中广泛应用于多种病症,包括结缔组织病和免疫性大疱性疾病、血管炎、皮炎、嗜中性皮肤病及其他皮肤病,以及雄激素过多综合征。长期使用全身性糖皮质激素与显著且快速的骨质流失有关,这使患者骨折风险增加。因此,骨密度测量以及及时开始生活方式调整和药物治疗对未来骨骼健康至关重要。在许多专科中,使用几种美国食品药品监督管理局批准的药物来预防和治疗糖皮质激素诱导的骨质流失的情况并不一致。在本综述中,作者总结了美国风湿病学会发布的关于预防和治疗糖皮质激素诱导的骨质流失的指南,并用最新批准的药物治疗描述和便于使用的流程算法对这些指南进行补充。本总结应有助于皮肤科医生为使用全身性糖皮质激素的患者提供有关骨骼健康的教育和建议。