Steroid-induced Osteoporosis in Autoimmune Bullous Disease: Clinical and Laboratory Evaluation in Eighteen Patients on Long-term Systemic Steroid Therapy

Abstract

Osteoporosis is the most frequent adverse effect of systemic steroid therapy. However, there have been only a few studies examining steroid-induced osteoporosis. We evaluated 18 patients (7 patients with pemphigus vulgaris, 4 patients with pemphigus foliaceus and 7 patients with bullus pemphigoid) for steroid-induced osteoporosis. Our study showed that these patients received high doses of corticosteroid for prolonged periods. There were 2 patients with osteoporosis and 9 patients with osteopenia. Bone fracture occurred in 4 patients (1 patient with osteoporosis, 1 patient with osteopenia and 2 patients who have normal bone mineral density). We measured bone turnover markers such as urine amino-terminal N-telopeptide of typeI collagen (NTx) in 7 patients who received bisphosphonates. Most of these patients had increases in BMD and decreases in urine NTX. It is necessary to have regular monitoring and effective therapy with steroid-induced osteoporosis in dermatological patients.