Suspected Case of Iatrogenic Cushing Syndrome Due to Topical Steroid.
- Author:
Hyun Dai KIM
1
;
Tai Hyok WON
;
Phil Seung SEO
;
Nyung Hoon YOON
;
Seok Don PARK
Author Information
1. Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea. ynh3@wonkwang.ac.kr
- Publication Type:Case Report
- Keywords:
Annular pustular psoriasis;
Iatrogenic Cushing syndrome;
Topical steroid
- MeSH:
Axis, Cervical Vertebra;
Cushing Syndrome*;
Flushing;
Humans;
Hydrocortisone;
Hypertrichosis;
Obesity, Abdominal;
Prescriptions;
Psoriasis
- From:Korean Journal of Dermatology
2007;45(9):947-950
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Chronic exogenous steroid therapy can result in hypothalamic-pituitary-adrenal axis dysfunction; this usually results from systemic steroid therapy, and is rarely associated with topical steroid therapy. We report a case of suspected iatrogenic Cushing syndrome that developed after the treatment of annular pustular psoriasis. The patient applied clobetasol-17-propionate cream (Betabate(R)) 15~30 g daily, for 4 months, without a dermatologist's prescription. After 4 months of application, the following symptoms developed; a moon face; facial flushing; hypertrichosis; central obesity; purple striae; and multiple erythematous scaly annular patches. The development of Cushing syndrome from exogenous corticosteroid treatment was supported by the typical clinical manifestations and the low basal state of the blood cortisol level, which was perhaps due to secondary suppression of the hypothalamic pituitary-adrenal axis. Steroid-containing drugs, especially during childhood, should be used with caution and monitored carefully.
