ASSESSMENT OF BONE MINERAL DENSITY BY DUAL X-RAY ABSORPTIOMETRY (DXA) IN DERMATOLOGICAL PATIENTS TREATED BY CORTICOSTEROIDS

Background. Corticosteroids are a well known cause of osteoporosis. Objective. This work was carried outto study the influence of systemic intake of corticosteroids, either by the oral route or by IV pulse administration, on bone mineral density in dermatological patients using DXA. Patients and methods. This study was carried on 100 patients and 55 controls. The first group of patients included 55 patients on longterm daily oral corticosteroids and the second group included 45 patients who received IV dexamethasone pulse therapy. DXA was measured once for both the controls and patients in group 1. DXA was measured twice for patients in group 2, before starting pulse therapy (baseline DXA) and 6 months after regular treatment with pulse therapy (follow up DXA). Results. Results show that significant reduction in BMD occurs in both groups, however oral corticosteroids produces significantly more reduction in BMD at the lumbar spine. BMD was not found to be affected by the cumulative doses of corticosteroids, the duration ofdaily oral corticosteroid intake or the number of IV dexamethasone pulses. Conclusion. Corticosteroid treatment causes significant BMD loss in patients treated by either routes. Prophylactic treatment againstosteoporosis is mandatory in patients receiving either fom of corticosteroids.