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Corticosteroids have anti-inflammatory, immunosuppressive, anti-proliferative, and vasoconstrictor actions. Many of these actions are mediated by the nuclear glucocorticoid receptor which modulates the transcription of proteins. This is considered to be the genomic mechanism and mediates many of the actions produced by the corticosteroids. Additionally, non-genomic mechanisms have been proposed to explain some of the immediate effects which cannot be explained by the classic glucocorticoid-receptor mechanism.
The corticosteroid receptor can be present in several isoforms. Corticosteroids produce their effects through the α-isoform, while relatively high levels of β-isoform may cause resistance to glucocorticoids. The glucocorticoid receptors are found in most of the cells of the body, which accounts for their widespread systemic effects. In the skin, glucocorticoid receptors have been located in keratinocytes and fibroblasts within the epidermis and dermis. medipharmas.shop
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Topical corticosteroids should not be used when there is known hypersensitivity to the corticosteroid or any component of the vehicle. Ulceration or bacterial, fungal, or viral infections being present are relative contra-indications to their use.
Topical corticosteroids tend to cause local ADRs more commonly, although systemic ADRs have been reported. The ADRs which have been seen commonly are listed. The use of more potent agents and/ or longer duration of therapy increases the chances of developing adverse drug reactions. The surface area of the skin, the total amount of drug used, skin integrity, and use of occlusive dressing are other risk factors. medipharmas.shop
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