Topical and systemic corticosteroids

Abstract

Corticosteroids belong to the most important anti-inflammatory substances in dermatology and in consequence play also a major role for the treatment of occupational skin diseases. The chemical structure of cyclopentanoperhydrophenanthrene builds the basis for all topical CS. The classification of topical corticosteroids covers four classes. Steroids have a three-dimensional structure and for activation steroids must be a fusion between the hydrocarbon skeleton and the specific glucorticoid receptor. In dermatology, the three effects of corticosteroids of primary importance are anti-inflammatory, antiproliferative and immune suppressive effects. In occupational dermatology, topical CS are the first-line treatment in allergic contact eczema due to their anti-inflammatory effects. Local adverse events and systemic side effects should be considered. Systemic corticosteroid treatment-no indication for corticosteroids in occupational dermatology.