Severe hypertension in childhood due to prolonged skin application of a mineralocorticoid ointment.
We report the case of a 9-year-old boy suffering from exzematous dermatitis who was treated for 6 years with a daily dose of 100 mg of a dermatological ointment containing 9 alpha-fluoroprednisolone-21-acetate. At examination the patient's blood pressure was persistently 230/160 mm Hg and was considered essential in origin after secondary forms of arterial hypertension had been excluded. Treatment with nifedipine and labetalol lowered the blood pressure to 150/100 mm Hg. When we became aware of the dermatological treatment, we advised its discontinuance. In the subsequent 7 days, the blood pressure fell to hypotensive levels (75/40 mm Hg) and then became normal a few days after discontinuance of the antihypertensive therapy. This case suggests that prolonged use of topical steroids, commonly prescribed for skin diseases, may cause hypertension, especially in childhood.
D000287:Administration, Topical; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D004485:Eczema / Q000188:drug therapy; D005477:Fluprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000188:drug therapy; D007741:Labetalol / Q000627:therapeutic use; D008297:Male; D009543:Nifedipine / Q000627:therapeutic use; D013997:Time Factors
C065592:isoflupredone acetate; D005477:Fluprednisolone; D009543:Nifedipine; D007741:Labetalol