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I have often written about the need to prevent and treat osteopenia and osteoporosis in patients receiving corticosteroid therapy for chronic skin disease. Lupus erythematosus, dermatomyositis, chronic eczemas, pemphigus, and pemphigoid (among other conditions) are often managed with systemic corticosteroids. Patients taking the equivalent of 5 mg/day or more of prednisone are at risk and should be prescribed oral calcium, vitamin D, and a bisphosphonate. Standard bisphosphonate dosing schedules include 70 mg/week of alendronate, 35 mg/week (or 150 mg/month) of risedronate, or 150 mg/month of ibandronate. For patients who fail to benefit from bisphosphonates, subcutaneous injection of 20 µg/day of teriparatide may be more effective (see JW …