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Related Concept Videos

Adrenal Gland Disorders01:27

Adrenal Gland Disorders

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Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
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Cushing Syndrome I: Introduction01:26

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Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the...
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Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

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Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features...
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Hormones of the Adrenal Glands01:31

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Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
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Anatomy of the Adrenal Glands01:17

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The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
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Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
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Related Experiment Video

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A Novel Method: Super-selective Adrenal Venous Sampling
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Topical steroid risk analysis: differentiating between physiologic and pathologic adrenal suppression.

Ethan Levin1, Rishu Gupta, Daniel Butler

  • 1Department of Dermatology, Psoriasis and Skin Treatment Center, University of California, San Francisco , San Francisco , California .

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Topical corticosteroids are generally safe for skin conditions. While some adrenal suppression can occur, it rarely causes clinical issues when used as directed, making them safe for long-term management.

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Area of Science:

  • Dermatology
  • Endocrinology

Background:

  • Topical corticosteroids are primary treatments for inflammatory skin conditions.
  • A potential systemic risk of topical steroid use is hypothalamic-pituitary-adrenal (HPA) axis suppression.
  • Distinguishing between pathologic and physiologic adrenal suppression is crucial.

Purpose of the Study:

  • To review data on HPA axis suppression risk from long-term topical steroid use.
  • To differentiate between pathologic and physiologic adrenal suppression.

Main Methods:

  • A systematic literature search was conducted on PubMed.
  • Studies evaluating HPA axis suppression risk associated with topical steroid use were reviewed.

Main Results:

  • 15 of 16 trials found no pathologic adrenal suppression.
  • Pathologic suppression occurred in one trial with excessive clobetasol propionate use.
  • Physiologic suppression was observed within 1-2 weeks of using class I-IV topical corticosteroids, often resolving spontaneously.

Conclusions:

  • Topical corticosteroids are unlikely to cause clinical HPA axis suppression.
  • When used within safety guidelines, topical steroids are extremely safe for managing skin disorders.