Adrenal Suppression following Low-Dose Topical Clobetasol Propionate

Ohman, E. Magnus; Rogers, Susanne; Meenan, F. O. C.; McKenna, T. J.

doi:10.1177/014107688708000709

Cited by 63 publications

(43 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…81 As little as 2 g per day of clobetasol propionate, 0.05% cream, can cause a decreased morning cortisol level after J AM ACAD DERMATOL VOLUME 54, NUMBER 1 only a few days. 82,83 Along the same lines, iatrogenic Cushing syndrome has been associated with the use of topical corticosteroids. 84,85 In rare cases, corticosteroid-related Addison crises have caused death.…”

Section: Suppression Of the Hypothalamic-pituitaryadrenal (Hpa) Axismentioning

confidence: 97%

Adverse effects of topical glucocorticosteroids

Hengge

Ruzicka

Schwartz

et al. 2006

Journal of the American Academy of Dermatology

925

682

View full text Add to dashboard Cite

Section: Suppression Of the Hypothalamic-pituitaryadrenal (Hpa) Axismentioning

confidence: 97%

Adverse effects of topical glucocorticosteroids

Hengge

Ruzicka

Schwartz

et al. 2006

Journal of the American Academy of Dermatology

925

682

View full text Add to dashboard Cite

“…Although topical corticosteroids are prescribed worldwide many times per day, corticosteroid-induced adrenal suppression has rarely been seen and reported on clinical investigation [16,17]. Appropriately used topical corticosteroids may lead to intermittent suppression of the HPA axis, with no clinical implications.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Insufficiency as a Result of Long-Term Misuse of Topical Corticosteroids

Böckle¹,

Jara

Nindl³

et al. 2014

Dermatology

View full text Add to dashboard Cite

The treatment of chronic inflammatory skin disease is associated with the use of topical corticosteroids. Their efficacy, tolerability and adverse effects depend on several factors, specifically potency, type of preparation, extemporaneous dilutions, quantity used, magnitude of the treated body surface, frequency of application, location, patient age, method of application and condition of the skin barrier. We report on two men suffering from chronic inflammatory skin disease, who presented with fatigue and cushingoid appearance after prolonged self-application of potent corticosteroids. Impairment of the skin barrier due to their underlying skin disease, frequent self-application of topical steroids and repeated application of the entire body led to extensive absorption of these substances, eventually culminating in the suppression of the pituitary-hypothalamic-adrenal axis. In conclusion, topical corticosteroids are effective and well-established therapeutic modalities. However, inappropriate use of topical corticosteroids can cause side effects.

show abstract

“…Suppression of the hypothalamicpituitary-adrenal axis occurred in an adult using as little as 7.5 mg of clobetasole propionate a week. 22 Treatment with this drug should not exceed two weeks or as the disease improves, a weaker corticosteroid should be substituted.…”

Section: Discussionmentioning

confidence: 99%

Topical Corticosteroids: Clinical Examples of Abuses

1995

View full text Add to dashboard Cite

Topical corticosteroids became available for use in 1952 when compound F or hydrocortisone was introduced. Modification of the basic corticosteroid molecule, e.g. by hallogenation or the optimization of the vehicle, enhances their effectiveness, the former by raising the potency 1 and the latter by increasing the percutaneous absorption. Case ReportsCase 1: A four-month-old female, product of a full term spontaneous vaginal delivery, presented to King Fahd Hospital of the University, Al Khobar, Saudi Arabia with generalized body swelling of two months' duration. The infant was normal up to the age of two months when she developed skin lesions in the face and diaper area. She was treated with clobetasol propionate 0.05% (dermovate cream) three to four times daily. After the lesions had healed, the mother continued to use the drug as a routine application to the napkin area. A total of eight tubes were consumed in a period of two months. Upon arrival at the hospital, the baby had an attack of generalized tonic-clonic convulsions with rolling of the eyes. Her vital signs on admission were temperature 38°C, pulse rate 180, blood pressure 120/100 mm/Hg and respiratory rate 54/min. She was comatose, responding only to painful stimuli. There was swelling of the trunk, fullness of the face, enlargement of the neck and a buffalo hump (Figure 1). Additionally, there were erythematous and acneiform lesions on the face and ecchymoses of the diaper area. Examination of the CNS showed hypertonia, brisk tendon reflexes and an upgoing plantar sign. The rest of the physical examination was within normal limits. CT scan of the brain showed cerebral and ventricular hemorrhage. Her morning serum Cortisol level was 3.4 μg/dL (normal value 8-28 μg/dL). Case 2: A 32-year-old male presented to the dermatology clinic, King Fahd Hospital of the University, with a three month history of an itchy skin lesion in the left groin. Before his referral to us, the patient was prescribed the following drugs over a period of two months: three tubes of betamethasone 0.05% dipropionate cream (diprosone), two tubes of flucinolone acetonide 0.025% cream (synalar) and two tubes of triamcinolone acetonide 0.1%, nystatin

show abstract

Adrenal Suppression following Low-Dose Topical Clobetasol Propionate

Cited by 63 publications

References 15 publications

Adverse effects of topical glucocorticosteroids

Adverse effects of topical glucocorticosteroids

Adrenal Insufficiency as a Result of Long-Term Misuse of Topical Corticosteroids

Topical Corticosteroids: Clinical Examples of Abuses

Contact Info

Product

Resources

About