title: Cushing's syndrome caused by topical steroid therapy for psoriasis.
abstract: A 72-year-old woman developed manifestations of Cushing's syndrome after long-term topical steroid therapy for psoriasis. Shortly after tapering the dose of topical steroids she developed signs of adrenal insufficiency (provoked by a urinary tract infection) requiring intravenous administration of a stress dose of hydrocortisone. There have only been a few reports of systemic side effects of topically applied corticosteroids in adults. Considering their serious consequences physicians should be alert to signs of Cushing's syndrome in patients on long-term topical steroid therapy. Furthermore, clobetasol propionate ointment doses exceeding 50 g a week should not be prescribed and use of occlusive dressings should be avoided.
authors.affiliation: Medical Centre Leeuwarden, Department of Internal Medicine, The Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Abma
authors.forename: R
authors.initials: R
authors.lastname: Blanken
authors.forename: L J M
authors.initials: LJ
authors.lastname: De Heide
mesh_terms: D000287:Administration, Topical; D000309:Adrenal Insufficiency / Q000139:chemically induced; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D002990:Clobetasol / Q000009:adverse effects* / Q000031:analogs & derivatives*; D003480:Cushing Syndrome / Q000139:chemically induced*; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D002990:Clobetasol