Psoriasis Center at Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany.
J Eur Acad Dermatol Venereol. 2013 Aug;27(8):1022-5. doi: 10.1111/j.1468-3083.2012.04656.x. Epub 2012 Jul 25.
The use of systemic steroids in the treatment of psoriasis is not recommended by dermatological textbooks and guidelines because of the risk of disease deterioration after dose reduction or withdrawal. In contrast to these recommendations, a recent analysis using data from a German nationwide healthcare insurance revealed that systemic steroids were the most frequently prescribed drugs for psoriasis by general practitioners, internal medicine physicians and dermatologists.
As there is an obvious discrepancy between the use of systemic steroids for psoriasis and the reported adverse effects, a non-systematic literature search starting 1950 until today was performed to address beneficial and adverse effect of systemic steroids in psoriasis.
Non-systematic literature search.
Regarding the widespread use of systemic steroids in psoriasis and other medical conditions taking the high prevalence of psoriasis of 2-3% at least in Caucasians into consideration, there is a remarkable lack of literature addressing adverse effects such as rebound, pustular or erythrodermic flares or even new occurrence of psoriasis in patients with a negative disease history.
A re-evaluation of the treatment of psoriasis and/or psoriatic arthritis with systemic steroids is necessary.
由于减少或停止剂量后疾病恶化的风险，皮肤科教科书和指南均不建议使用全身性皮质类固醇治疗银屑病。与这些建议相反，最近一项使用德国全国医疗保健保险数据进行的分析显示，全身性皮质类固醇是普通医生、内科医生和皮肤科医生治疗银屑病最常开的药物。
鉴于银屑病使用全身性皮质类固醇与报告的不良反应之间存在明显差异，因此进行了从 1950 年至今的非系统性文献检索，以探讨全身性皮质类固醇在银屑病中的有益和不良反应。
非系统性文献检索。
鉴于全身性皮质类固醇在银屑病和其他医学病症中的广泛应用，考虑到银屑病的高发率至少为 2-3%（尤其是在白种人中），对于诸如反弹、脓疱性或红皮病样发作，甚至对于有阴性病史的患者新出现银屑病等不良反应，相关文献明显缺乏。
有必要重新评估全身性皮质类固醇治疗银屑病和/或银屑病关节炎。
