Indications – Condition is associated with systemic disease, very severe disease, topical drug is inactive• Severe, allergic/hypersensitivity reactions• Dermatitis – atopic, contact, exfoliative, seborrheic• Psoriatic/gouty arthritis• Pemphigus/pemphigoid• Systemic lupus erythematous/Discoid lupus erythematous• Multiple sclerosis• Steven-Johnson syndrome/Toxic epidermal necrolysis• Erythema multiforme• Idiopathic thrombocytic purpura

Complications• Skin thinning – Easy bruising, skin tearing, slow healing, stretch marks• Hair thinning• Acne• Redistribution of body fat – Moon face, red cheeks, buffalo hump, truncal obesity• Increased appetite• Weight gain• Triglyceridemia• Hyperglucosemia – Diabetes mellitus• Shakiness, tremor• Reduction in growth (children)• Hypocalcemia – Osteoporosis (smokers, postmenopausal women, elderly, underweight, immobile, diabetes)• Immunosuppression• Reduction of own cortisol production• Psychological effects – Increased/decreased energy, mania, psychosis, insomnia, mood changes, excitement, delirum/depression• Salt retention – Leg swelling, raised blood pressure, weight increase, heart failure