Letters to the Editors: 1

Hypertension and other morbidities with Cushing’s syndrome associated with corticosteroids: a review

“…Oral corticosteroid therapy has been well correlated with CS, and most physicians are aware of the dangers, having always to balance the cost–effect ratio 2. According to accumulated data, topical, aerosol, inhaled, and injectable corticosteroid therapy may also have adverse effects, including CS 2,8–12. There have been several cases of children who received intralesional injections into keloid scars or other wounds (such as burns) and developed CS that persisted for a long time (up to 9 months) 13.…”

Fatal Disseminated Cytomegalovirus Infection in an Infant with Cushing’s Syndrome Caused by Topical Steroid

“…It is also very rare in infancy. However, topical application of potent corticosteroids can cause Cushing’s syndrome, as well as suppression of the hypothalamic-pituitary-adrenal axis [4,5,6,7]. Sufficient exogenous glucocorticoids can be absorbed through the skin and can result in Cushing’s syndrome.…”

“…Sufficient exogenous glucocorticoids can be absorbed through the skin and can result in Cushing’s syndrome. Clobetasol propionate (0.05%) is the most potent topical corticosteroid available and there are reports of adrenal suppression due to its prolonged use [4,5,6]. …”

Drugs and HPA axis

“…Iatrogenic Cushing's syndrome has also been reported in a few patients treated with inhaled glucocorticoids and drugs such as itraconazole and clarithromycin, which inhibit hepatic cytochrome P450 3A (CYP3A), thus increasing glucocorticoid bioavailability [4][5][6]. Continuous cutaneous application of glucocorticoid preparations (e.g., ointments) on injured skin may also cause the development of iatrogenic Cushing's syndrome [7][8][9]. In the abovementioned circumstances, measurement of serum and urinary cortisol will yield variably increased levels in patients administered cortisone, hydrocortisone, prednisone and prednisolone as these drugs cross-react in most cortisol assays.…”