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[Adrenal function in topic corticotherapy].
Archivos De Investigacion Medica
|January 1, 1978
Summary
Topical corticosteroids, like fluorocorticoids, can suppress adrenal function in children with dermatoses. Even short-term use may impact cortisol levels, especially with extensive skin involvement.
Area of Science:
- Pediatric Endocrinology
- Dermatology
- Pharmacology
Background:
- Corticosteroids are widely used for dermatological conditions.
- Concerns exist regarding their systemic effects and potential for misuse.
- Adrenal suppression is a known side effect of corticosteroid therapy.
Purpose of the Study:
- To investigate the impact of topical fluorocorticoids on adrenal function in children.
- To assess urinary 17-ketosteroids, 17-ketogenicsteroids, and serum cortisol levels.
- To evaluate the duration of adrenal suppression after treatment cessation.
Main Methods:
- A study involving 29 ambulatory children aged 3-15 with dermatoses.
- Two-week non-occlusive treatment with 0.01% fluorocorticoids.
- Measurement of urinary 17-ketosteroids, 17-ketogenicsteroids, and serum cortisol before, during, and after treatment.
- Control measurements at 24 hours and 8 days post-treatment.
Main Results:
- A significant decrease in urinary 17-ketogenicsteroids was observed post-treatment, with rapid recovery.
- Children with over 30% skin involvement showed a decrease in serum cortisol.
- This cortisol decrease persisted for 24 hours after treatment cessation, normalizing by 8 days.
Conclusions:
- Topical glucocorticoids can inhibit hypothalamic-pituitary-adrenal (HPA) axis function.
- The degree of adrenal suppression may correlate with the extent of skin affected.
- Careful monitoring and judicious use of topical corticosteroids in pediatric dermatology are warranted.