title: Cushing's syndrome and chronic venous ulceration--a clinical challenge.
abstract: Cushing's syndrome is a condition caused by high levels of glucocorticoids, or most commonly as a result of prolonged exposure to exogenous steroids. Clinical features include diabetes, hypertension, obesity, skin atrophy, immune suppression and delayed wound healing. We report a patient with iatrogenic Cushing's syndrome, in whom long-term topical steroid therapy was used to treat varicose eczema, which contributed to the development of type 2 diabetes, morbid obesity, sleep apnoea and chronic wound sepsis. In this case, repeated hospital admissions and systemic antibiotics were associated with considerable comorbidity. Aggressive local treatment, consisting of potassium permanganate soaks and irrigating gels, was highly effective in reducing the amount of exudate, pain and preventing from further deterioration of the patient's legs.
authors.affiliation: Department of Diabetes, Royal Gwent Hospital, Newport, UK. mousumi.biswas@gwent.wales.nhs.uk
authors.forename: Moushmi
authors.initials: M
authors.lastname: Biswas
authors.forename: Owain
authors.initials: O
authors.lastname: Gibby
authors.forename: Tzvetanka
authors.initials: T
authors.lastname: Ivanova-Stoilova
authors.forename: Keith
authors.initials: K
authors.lastname: Harding
mesh_terms: D000287:Administration, Topical; D000368:Aged; D001458:Bandages; D002908:Chronic Disease; D003480:Cushing Syndrome / Q000097:blood / Q000150:complications*; D005260:Female; D005938:Glucocorticoids / Q000097:blood; D006801:Humans; D011196:Potassium Permanganate / Q000008:administration & dosage*; D014647:Varicose Ulcer / Q000209:etiology* / Q000628:therapy
chemical_list: D005938:Glucocorticoids; D011196:Potassium Permanganate