Adrenal insufficiency and diabetes mellitus secondary to the use of topical corticosteroids for cosmetic purpose.
We report a case of symptomatic topical corticosteroid-induced adrenal insufficiency and diabetes in a 46-yr old HIV 1 positive woman of African descent. Topical Betamethasone dipropionate 0.05%-containing creams were used for the purpose of bleaching over a 2 month period prior to the acute episode. She recovered from her acute onset diabetes with ketosis and adrenal insufficiency a few months after withdrawal of corticosteroids. Despite possible discussion about pathophysiology of diabetes because acute-onset remitting diabetes is not rare in patients of African descent, and diabetes may occur in patients taking anti-retroviral treatments, no other cause of a hypothalamo-pituitary-adrenal axis disorder was found. This case suggests that chronic use of high dose topical corticosteroid containing creams should be ruled out in patients presenting with Hypothalamo-Pituitary-Adrenal hypofunction.
Sobngwi
E
E
Department of Endocrinology and Diabetes, St-Louis University Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France. e.sobngwi@wanadoo.fr
Lubin
V
V
Ury
P
P
Timsit
F-J
FJ
Gautier
J-F
JF
Vexiau
P
P
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000287:Administration, Topical; D000309:Adrenal Insufficiency / Q000139:chemically induced*; D017954:Africa South of the Sahara / Q000208:ethnology; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001623:Betamethasone / Q000009:adverse effects* / Q000031:analogs & derivatives*; D003920:Diabetes Mellitus / Q000139:chemically induced*; D005260:Female; D005602:France; D005938:Glucocorticoids; D006801:Humans; D008875:Middle Aged
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone