A patient with pemphigus vulgaris, treated with long term corticosteroids, developed avascular necrosis of the head of the femur and humerus, bilaterally. This patient emphasizes the fact that the use of corticosteroids in dermatologic disorders may be a predisposing cause in avascular necrosis, and that this is another side effect of long-term corticosteroid therapy. This patient is particularly remarkable in that both hips and both shoulders were involved.
EPSTEIN NN, TUFFANELLI DL, EPSTEIN JH. Avascular Bone NecrosisA Complication of Long-Term Corticosteroid Therapy. Arch Dermatol. 1965;92(2):178–180. doi:10.1001/archderm.1965.01600140066017