title: A case of multiple bone fractures due to the use of topical corticosteroid therapy for psoriasis.
abstract: A 45-year-old man who had psoriasis had applied topical clobetasol 17 propionate ointment on his whole body 2-3 times a week after the bath for 20 years. Physical examination showed abdominal distension, atrophy all over the skin, psoriatic plaques on the trunk, and extremities and multiple striae on the shoulders and legs. Morning plasma cortisol level and ACTH stimulation test confirmed the diagnosis of hypothalamic insufficiency. Bone mineral densitometry showed severe osteoporosis. Multiple bone fractures in the vertebrae and costa were detected on lumbar magnetic resonance imaging, the (99)Tc MDP whole-body bone scan, and thoracoabdominal computerized tomography imaging. Topical corticosteroid therapies have possible local and/or systemic side effects such as atrophy, telangiectasia, hypertricosis, and suppression of pituitary-adrenal axis. We present an interesting case with multiple bone fractures caused by long-time topical corticosteroid use.
authors.affiliation: Department of Dermatology, Dışkapı Yıldırım Beyazıt Education and Research Hospital , Ankara , Turkey and.
authors.forename: Müzeyyen
authors.initials: M
authors.lastname: Gönül
authors.forename: Engin
authors.initials: E
authors.lastname: Gönül
mesh_terms: D000287:Administration, Topical; D002990:Clobetasol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D050723:Fractures, Bone / Q000139:chemically induced*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000378:metabolism; D011565:Psoriasis / Q000188:drug therapy*
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids; D002990:Clobetasol
keywords: Bone fracture; psoriasis; topical corticosteroid