title: Iatrogenic Cushing's syndrome and topical steroid therapy: case series and review of the literature.
abstract: Topical corticosteroids are considered first-line therapy in patients with chronic inflammatory oral mucosal diseases; among them, clobetasol propionate is one of the most widely used in oral medicine. Under physiological conditions, the transmucosal application is characterized by a significantly greater absorption than the skin application. Contrary to many publications about the side effects of topical corticosteroids in dermatology, few studies have investigated the systemic effects due to local application of these drugs on oral mucosa. Although topical steroid therapy for the management of oral diseases is generally associated with local adverse effects (candidiasis, stomatopyrosis, and hypogeusia), these drugs can also lead to systemic side effects, such as suppression of the hypothalamic-pituitary-adrenal axis and Cushing's syndrome. This review reports five cases of systemic adverse effects caused by clobetasol propionate topical treatment.
authors.affiliation: Dipartimento di scienze biomediche, chirurgiche e odontoiatriche, Università degli Studi di Milano , Milano , Italy.
authors.forename: Sem
authors.initials: S
authors.lastname: Decani
authors.forename: Veronica
authors.initials: V
authors.lastname: Federighi
authors.forename: Elisa
authors.initials: E
authors.lastname: Baruzzi
authors.forename: Andrea
authors.initials: A
authors.lastname: Sardella
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lodi
mesh_terms: D000287:Administration, Topical; D002990:Clobetasol / Q000008:administration & dosage / Q000009:adverse effects*; D003480:Cushing Syndrome / Q000139:chemically induced*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D017676:Lichen Planus, Oral / Q000188:drug therapy*; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000188:drug therapy*
chemical_list: D005938:Glucocorticoids; D002990:Clobetasol