Effect of glucocorticosteroid therapy on the immune system of patients with nonimmunologically mediated dermatoses

Humoral and cellular immunologic studies were carried out to define the effect of steroid treatment on the immune system of patients with non-immunologically-mediated dermatoses. The cellular immune response as measured by PHA and Con A induced lymphoblastogenesis was highly impaired, being reduced in 79% and 66%, respectively, of the cases. The peripheral and bone marrow lymphocyte subpopulation and PPD skin reaction were only slightly affected by steroid administration. Histologic studies of lymph node biopsies showed atrophy, fibrosis and fat degeneration. The immunoglobulin and complement levels and humoral antibody responses to typhoid vaccine, diphtheria toxoid and bacteriophage phi--x 174 were mildly affected. The impairment of immune systems induced by steroids was largely reversible, while the PHA induced blastogenesis and pathological changes in the lymph nodes were irreversible. In comparison with experimental animal studies using massive doses of steroids, the immune system in man was not significantly affected by administration of small doses on a long term basis in clinical practice.