title: Influence of topical corticosteroids on hormones in urine and plasma.
abstract: In the present study the effects on endogenous hormones of application of topical corticosteroids are investigated. Radioimmunological assays of the hormones cortisol, adrenocorticotrophic hormone (ACTH) and alpha-melanocyte stimulating hormone (alpha-MSH) before, during and after a large-area treatment with topical corticosteroids (30 g/d 0.025% fluocinolone acetonide ointment for 9 days) are performed in eight patients suffering from extensive inflammatory dermatoses (7 cases of eczema, 1 case of psoriasis). Cortisol was measured in plasma daily under treatment. In addition, gas chromatographic and mass spectrometric determinations of urocorticoids and uroandrogens are carried out in 24-h urine. A distinct, treatment-induced suppression of the endogenous steroid production was significant (-42.7%, p less than or equal to 0.05) within the first four days and diminished (-24.4%, p less than or equal to 0.10) after nine days' steroid therapy. The suppression of the plasma ACTH was also significant (-23.1%, p less than or equal to 0.05). The alpha-MSH level did not show any alterations. The measured urocorticoids showed an average fall of -38.9% (p less than or equal to 0.05). It is noteworthy that despite continued steroid treatment the marked initial suppression of the endogenous steroid production diminishes. It is possible that a therapy-induced "normalization" of the epidermis brings about a diminished steroid influx and thus a lower systemic load. Under the therapy conditions chosen here, the androgen metabolites in the urine did not show any significant fluctuations.
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000494:pharmacology*; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D002849:Chromatography, Gas; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006728:Hormones / Q000097:blood / Q000378:metabolism* / Q000652:urine; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D009074:Melanocyte-Stimulating Hormones / Q000097:blood; D008875:Middle Aged
chemical_list: D000305:Adrenal Cortex Hormones; D006728:Hormones; D000324:Adrenocorticotropic Hormone; D009074:Melanocyte-Stimulating Hormones; D006854:Hydrocortisone