Background: Prolonged application of topical steroids transiently suppresses the hypothalamicpituitary-adrenal axis (ΗΡΑ). Infants who are exposed to topical corticosteroids have greater risk for Cushing's syndrome or adrenocortical insufficiency caused by suppression of the ΗΡΑ axis because glucocorticoids are highly absorbed through the diaper area. Here, we report six infants (four girls, two boys) aged between 3 and 8 months who were exposed to potent topical corticosteroids (clobetasol propionate and diflucortolone valerate) by the mother's application without prescription. Methods: We examined the ΗΡΑ axis and other side effects of the potent glucocorticoid therapy in these infants. After stopping the topical corticosteroid, serum AST, ALT, lipids, morning Cortisol and ACTH levels were measured. A low dose ACTH stimulation test was carried out. Hydrocortisone was started for the prevention of glucocorticoid withdrawal syndrome and the dose was gradually decreased. Abdominal ultrasonography was performed to investigate hepatosteatosis. Results: The ACTH stimulation test showed suppression of the ΗΡΑ axis in these infants.Hepatomegaly was found in all infants and three of them had hepatosteatosis. Liver transaminase levels were elevated in five infants. Five patients have been followed for 6-14 months. One infant died due to generalized Cytomegalovirus infection. Conclusion:We emphasize that physicians should be alert for the dangerous side-effects of topical steroids and they should avoid long-term use. Furthermore, parents should be informed about the side-effects when topical steroid treatment is chosen. KEY WORDSCushing's syndrome, adrenal insufficiency, clobetasol propionate, diflucortolone valerate, infant

The parents of children with Type 1 diabetes reported emotional and behavioral problems significantly more. We did not find any significant association between the level of metabolic control and the emotional and behavioral problems.

In underweight children, decreased vaspin and apelin levels should be considered in the etiology of anorexia.

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The diagnosis of acromegaly requires a glucose-suppressed growth hormone (GH) nadir greater than 1 microg/l associated with clinical symptoms and signs. Here, we present a patient who has acromegalic clinical findings associated with a nadir GH level < 1 microg/l during an oral glucose tolerance test.

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