Cushing’s syndrome: hidden risk in usage of topical corticosteroids

Abstract Iatrogenic Cushing’s syndrome in children may occur as a result of the application of exogenous steroids. Prolonged use of powerful corticosteroids suppresses adrenal functions and iatrogenic Cushing’s syndrome may develop particularly in infants who are given topical corticosteroids. We report here a case on three infants having Cushing’s syndrome with similar clinical presentations due to overuse of topical steroids for diaper dermatitis. The importance of exercising caution during the use of topical steroids is underlined in this study.

[1]  Z. Aycan,et al.  Iatrogenic Cushing syndrome due to nasal steroid drops , 2012, European Journal of Pediatrics.

[2]  A. Last,et al.  Choosing topical corticosteroids. , 2009, American family physician.

[3]  Ş. Ergin,et al.  Two Cases of Cushing’s Syndrome Due to Overuse of Topical Steroid in the Diaper Area 1 , 2008, Pediatric dermatology.

[4]  L. Nield,et al.  Prevention, Diagnosis, and Management of Diaper Dermatitis , 2007, Clinical pediatrics.

[5]  N. Andıran.  "Diaper Dermatit"ten Cushing Sendromuna , 2007 .

[6]  Ayla Güven,et al.  Cushing's Syndrome and Adrenocortical Insufficiency Caused by Topical Steroids: Misuse or Abuse? , 2007, Journal of pediatric endocrinology & metabolism : JPEM.

[7]  L. Nieman,et al.  Cushing's syndrome , 2005 .

[8]  R. Schwartz,et al.  Adverse effects of topical glucocorticosteroids. , 2006, Journal of the American Academy of Dermatology.

[9]  J. Ferrari,et al.  Joint hypermobility: the use of a new assessment tool to measure lower limb hypermobility. , 2005, Clinical and experimental rheumatology.

[10]  Z. Şıklar,et al.  An Infantile Cushing Syndrome Due to Misuse of Topical Steroid , 2004, Pediatric dermatology.

[11]  A. Colao,et al.  The diagnosis of secondary adrenal insufficiency: Low dose vs high dose ACTH stimulation test , 2003, Journal of endocrinological investigation.

[12]  D. Allen.  Safety of inhaled corticosteroids in children , 2002, Pediatric pulmonology.

[13]  A. Wolkerstorfer,et al.  Efficacy and safety of wet‐wrap dressings in children with severe atopic dermatitis: influence of corticosteroid dilution , 2000, The British journal of dermatology.

[14]  M. Mulford,et al.  Super potent topical corticosteroid use associated with adrenal suppression: clinical considerations. , 1998, Journal of the American Academy of Dermatology.

[15]  P. Hindmarsh,et al.  Reproducibility of the cortisol response to stimulation with a low dose of ACTH(1-24): the effect of basal cortisol levels and comparison of low-dose with high-dose secretory dynamics. , 1993, The Journal of endocrinology.

[16]  F. Paliogianni,et al.  Glucocorticosteroid action on the immune system: molecular and cellular aspects. , 1991, Clinical and experimental rheumatology.