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Rosemarie H. Liu, MD; Joerg Albrecht, MD; Victoria P. Werth, MD

Arch Dermatol. 2006;142:37-41.

Objective  To examine whether patients had received bisphosphonates at the beginning of planned long-term glucocorticoid therapy, which is recommended by the guidelines from the American College of Rheumatology to prevent glucocorticoid-induced osteoporosis, prior to referral to a tertiary dermatology clinic.

Design  Cross-sectional study.

Setting  Tertiary referral center.

Patients  We reviewed 35 patients from an established cohort of patients referred with chronic skin diseases that require prolonged glucocorticoid use.

Main Outcome Measure  The use of osteoporosis prophylaxis was determined by medical chart review and communication with patients.

Results  Of 35 patients, 28 (80%) were not receiving any bisphosphonates at referral. These patients began glucocorticoid therapy 17 months (median, 6 months; range, 1-102 months) prior to referral. The proportion of patients treated with bisphosphonates in our cohort did not change after the guidelines of the American College of Rheumatology were published.

Conclusions  For patients of non–child-bearing potential with dermatological diseases in which prolonged oral corticosteroid treatment is anticipated, bisphosphonates should be prescribed concomitantly with the initiation of glucocorticoid therapy.

Author Affiliations: Eastern Virginia Medical School, Norfolk (Dr Liu); Department of Dermatology, University of Pennsylvania, Philadelphia (Drs Albrecht and Werth); and Veterans Administration Hospital, Philadelphia (Dr Werth).

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