title: Cushing syndrome from percutaneous absorption of 1% hydrocortisone ointment in Netherton syndrome.
abstract: Netherton syndrome is a congenital skin disease associated with decreased skin barrier function and increased percutaneous absorption. We report an 11-year-old boy with Netherton syndrome who developed Cushing syndrome after application of 1% hydrocortisone ointment to his entire body for more than 1 year. This presentation illustrates that even low-potency steroid ointments should be used with caution in Netherton syndrome and warns about the use of long-term topical medications with potential systemic side effects when used in large quantities in any chronic skin disease.
authors.affiliation: Departments of Internal Medicine (Dermatology) and Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Caroline P
authors.initials: CP
authors.lastname: Halverstam
authors.forename: Akshaya
authors.initials: A
authors.lastname: Vachharajani
authors.forename: Susan Bayliss
authors.initials: SB
authors.lastname: Mallory
mesh_terms: D000279:Administration, Cutaneous; D000893:Anti-Inflammatory Agents / Q000506:poisoning* / Q000627:therapeutic use; D002648:Child; D003480:Cushing Syndrome / Q000139:chemically induced*; D006801:Humans; D006854:Hydrocortisone / Q000506:poisoning* / Q000627:therapeutic use; D008297:Male; D009154:Mutation; D009824:Ointments; D053491:Proteinase Inhibitory Proteins, Secretory / Q000235:genetics; D011537:Pruritus / Q000188:drug therapy; D000074163:Serine Peptidase Inhibitor Kazal-Type 5; D012869:Skin Absorption; D012873:Skin Diseases, Genetic / Q000188:drug therapy*; D013577:Syndrome
chemical_list: D000893:Anti-Inflammatory Agents; D009824:Ointments; D053491:Proteinase Inhibitory Proteins, Secretory; C120650:SPINK5 protein, human; D000074163:Serine Peptidase Inhibitor Kazal-Type 5; D006854:Hydrocortisone