Topical glucocorticosteroids: from high clinical efficacy to the problem of uncontrolled use (case report)

Abstract

Due to their pronounced biological activity, glucocorticosteroids are widely used in various fields of medical practice. The variety of effects of these hormones makes them an important part of the treatment of dermatological patients. This group of drugs has a pronounced positive effect on various links in the pathogenesis of many chronic dermatoses due to anti-inflammatory, vasoconstrictive, immunosuppressive and antiproliferative effects. The creation of combined external preparations containing a glucocorticosteroid in  combination with an antibacterial and/or antifungal component has become a  significant achievement in dermatological practice. Due to the rapid relief of signs of inflammation, as well as additional antibacterial and antifungal effects, these external agents have become especially attractive to patients. Widespread advertising and over-the-counter sale of drugs containing glucocorticosteroids leads to the fact that a significant part of patients seek advice from a dermatologist only after their ineffective use. At the same time, their uncontrolled use can lead to a number of side effects, including both pathological changes in the skin and pronounced negative systemic reactions. This fact significantly changes the clinical picture of the disease, limits the possibilities of early laboratory diagnosis of infection, which often prolongs the time for verification of the diagnosis and complicates therapy. The article presents our own clinical observations of patients with skin mycoses who have been using combined topical preparations containing glucocorticosteroids for a long time. This led to an atypical clinical course of the infection and required additional diagnostics using histological examination. The analysis of clinical observations is intended to focus the attention of primary care physicians on this problem, which can increase patient awareness of the risks of using topical drugs containing glucocorticosteroids.