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Topical triamcinolone induced Cushing syndrome: A case report
Oliver Taylor1, Juan Diego Mejia-Otero1, Grace M Tannin1
1Departments of Dermatology and Pediatric Endocrinology, University of Texas Southwestern Medical School, Dallas, Texas.
Pediatric Dermatology
|March 27, 2020
Summary
Overuse of topical triamcinolone cream in infants can cause serious hormonal imbalances like Cushing syndrome and adrenal insufficiency. Careful prescribing and monitoring of potent steroids are crucial for pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Dermatology
- Pharmacology
Background:
- Diaper dermatitis is a common condition in infants.
- Topical corticosteroids are frequently prescribed for inflammatory skin conditions.
- Systemic absorption of topical steroids can occur, especially in infants.
Observation:
- A newborn developed iatrogenic Cushing syndrome and adrenal insufficiency.
- This was secondary to the overuse of 0.1% triamcinolone cream for diaper dermatitis.
- The infant experienced significant systemic absorption of the topical steroid.
Findings:
- Topical triamcinolone cream overuse can lead to significant endocrine disruption in neonates.
- The diaper area's unique physiology increases the risk of systemic steroid absorption.
- Diagnosis included hormonal assays confirming Cushingoid state and adrenal suppression.
Implications:
- Highlights the potential risks of systemic absorption of topical medications in infants.
- Underscores the importance of judicious prescribing of mid-potency topical steroids in pediatric patients.
- Emphasizes the need for close follow-up and parental education regarding topical steroid use in infants.
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