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Side effects of topical steroid use fall into two categories: Systemic side effects and local side effects.[33] Systemic systemic side effects occur when the steroids are absorbed via the skin and are most commonly reported with oral or topical use.[21] A few systemic side effects occur with short-term use of systemic steroids and can be resolved with discontinuation of the steroid. However, for reasons that are still poorly understood, systemic side effects may have a long-term impact on both the local and systemic immune system, possibly resulting in an increased risk of opportunistic infection.[21] Other systemic systemic side effects that can occur during long-term use of systemic steroids include cardiovascular and pulmonary side effects.[3,27] The vasoconstrictor effect of corticosteroids has been linked to pulmonary vasoconstriction, suggesting that this effect may occur with prolonged steroid use.[26] Local systemic steroid side effects include an increase in systemic inflammation.[6,16,25] The use of glucocorticoids, with or without other steroids, may increase peripheral blood flow, thereby increasing the risk of vasoconstriction,[28] and can contribute to hypoglycemia.[16] Acute adverse effects reported with low-dose oral steroids, including allergic reaction, anaphylactic shock and pulmonary edema.[16,24] Chronic effects of low-dose oral steroids include increased risk of mortality in patients with preexisting cardiac disease, osteoporosis, hypertension, diabetes mellitus, coronary artery disease or pulmonary hypertension. These side effects can occur both during the short-term (1 week-1 year) and the long-term (2 years). These side effects are most common during the short-term use of low-dose oral steroids. The most common long-term side effects of low-dose oral steroids include liver dysfunction or dysfunction.[16,14] The incidence and severity of these side effects vary widely by individual, and are more common in men than women.[19] Many of the side effects are more likely to occur in patients of darker skin tone than light skinned patients. The most serious long-term effects of low-dose oral steroids include increased risk of developing a new disease (such as kidney disease) at older ages, increased bone density loss at older ages, increases in the risk of osteoporosis, and increased risk of contracting HIV.[16,29] Effects of corticosteroids on heart function Cardiovascular Effects Of the cardiovascular side effects of low-dose oral steroids, most are related to vasoconstriction. Vasoconstriction, however, could have additional Related Article:
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