Skin Permeability

Schaefer, H.; Zesch, A; Stüttgen, Günter

doi:10.1007/978-3-642-67434-1_7

Cited by 3 publications

(1 citation statement)

References 692 publications

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“…Several factors influence the systemic absorption of topical steroids. The diseased skin results in loss of skin as a barrier resulting in some systemic absorption of the drug 4. Moreover, skin may act as a store resulting in delayed absorption even after single topical application 5.…”

Section: Discussionmentioning

confidence: 99%

Adrenal insufficiency secondary to inappropriate oral administration of topical exogenous steroids presenting with hypercalcaemia

Bhatti

Flynn²

2012

Case Reports

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A 59-year-old Caucasian gentleman presented with malaise, fatigue and proximal muscle weakness. He had history of long-standing roseate psoriasis treated with topical clobetasol propionate (dermovate). On admission, he had significant postural hypotension, and hypercalcaemia. Endocrinological investigation revealed hypercalcaemia, a serum cortisol of <30 nmol/l, a flat short synacthen test and undetectable adrenocorticotropic hormone. He was treated with hydrocortisone. The abrupt withdrawal of the topical steroids by the patient precipitated the addisonian crisis. Further enquiry documented inappropriate oral administration of clobetasol for more than 10 years in addition to prescribed topical usage.

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Section: Discussionmentioning

confidence: 99%

Adrenal insufficiency secondary to inappropriate oral administration of topical exogenous steroids presenting with hypercalcaemia

Bhatti

Flynn²

2012

Case Reports

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show abstract

Literatur

Pratzel

1987

Iontophorese

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Adrenal Suppression following Low-Dose Topical Clobetasol Propionate

et al. 1987

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The use of topical steroids is associated with adverse systemic effects such as suppression of the hypothalamic-pituitary-adrenal (HPA) axis, and application of more than 50 g per week of clobetasol propionate cream has been shown to cause secondary adrenal failure. We describe 4 patients who used clobetasol propionate cream over a prolonged period; 3 patients used less than 50 g per week (7.5, 25 and 30 g per week) and yet all developed secondary adrenal failure for up to 4 months after cessation of therapy. Adrenal insufficiency following prolonged use of clobetasol propionate in moderate dosages may therefore be more common than previously recognized. It is suggested that the metyrapone test, which conveniently examines the entire HPA axis, should be employed in patients receiving long-term topical clobetasol propionate cream and that glucocorticoid supplementation should be given during episodes of stress, such as infections and surgery, for up to 4 months after cessation of therapy.

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Skin Permeability

Cited by 3 publications

References 692 publications

Adrenal insufficiency secondary to inappropriate oral administration of topical exogenous steroids presenting with hypercalcaemia

Adrenal insufficiency secondary to inappropriate oral administration of topical exogenous steroids presenting with hypercalcaemia

Literatur

Adrenal Suppression following Low-Dose Topical Clobetasol Propionate

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