Corticosteroid Therapy

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Abstract
IN GENERAL, complications of corticosteroid therapy are the same as the manifestations of spontaneous Cushing syndrome. We shall discuss each of these complications. Abnormalities of Fat Distribution.— There is increased deposition of fat in the supraclavicular, cervicodorsal, and the anterior neck areas, as well as in the face, which becomes rounded. These complications produce cosmetic damage only, and cannot be overcome except by reduction of steroid dosage. Generalized obesity tends to occur and should be minimized by caloric restriction. Loss of Muscle Mass Causing Weakness and Fatigue.— The administration of corticotropin rather than of individual glucocorticoids, or the use of adjuvant therapy with an anabolic agent probably reduces muscle wasting but at the frequent expense of causing hirsutism. Skin Changes.— The skin becomes erythematous, especially over the face, becomes thinned (probably because of reduced protein content), loses its elasticity, and shows stretch marks or "striae" in areas overlying large deposits

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