title: Adrenal Suppression With Chronic Topical Corticosteroid Use in Psoriasis Patients.
abstract: BACKGROUND
  Topical corticosteroids (TCS) are typically used for extended periods of time for chronic skin conditions, including psoriasis. Chronic TCS use may result in side effects similar to those of systemic corticosteroids. Patients may have subclinical adrenal suppression and be unaware of their risk in the case of serious trauma.<BR />
  
  
  OBJECTIVE
  The objective of this study was to investigate the real world effects of chronic TCS use and its effects on adrenal suppression in a chronic disease such as psoriasis.<BR />
  
  
  METHODS
  This retrospective study utilized data from screening visits of a psoriasis clinical trial in which subjects had been on chronic TCS.<BR />
  
  
  RESULTS
  In this study, subjects with moderate to severe psoriasis affecting 16-20% of total body surface area (BSA) and using high-potency TCS at screening had a lower post-cosyntropin cortisol level (18.83 mcg/dL) compared to those with moderate psoriasis involving 10-15% of total BSA and using lower potency TCS at screening (23.22 mcg/dL; P=0.03). Both subject groups had lower post-cosyntropin cortisol levels compared to normal, healthy adults (<em>P</em>&lt;0.001 for both).<BR />
  
  
  CONCLUSIONS
  This suggests that real world chronic use of high potency TCS over a larger BSA may result in silent adrenal suppression.<BR /><BR /> <em>J Drugs Dermatol</em>. 2016;15(8):945-948.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Lam
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Sugarman
mesh_terms: D000279:Administration, Cutaneous; D000305:Adrenal Cortex Hormones / Q000037:antagonists & inhibitors / Q000097:blood*; D000328:Adult; D000368:Aged; D001830:Body Surface Area; D003366:Cosyntropin / Q000037:antagonists & inhibitors / Q000097:blood; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006854:Hydrocortisone / Q000037:antagonists & inhibitors / Q000097:blood; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids; D003366:Cosyntropin; D006854:Hydrocortisone