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Cushing's syndrome from topical glucocorticoids
S Teelucksingh1, M Bahall, D Coomansingh
1Department of Medicine, Port-of-Spain General Hospital, Trinidad.
The West Indian Medical Journal
|June 1, 1993
Summary
A woman developed Cushing's syndrome from prolonged topical glucocorticoid use for psoriasis. Discontinuation of steroids resolved symptoms, highlighting concerns about over-the-counter access to potent corticosteroids.
Area of Science:
- Endocrinology
- Dermatology
Background:
- Psoriasis management often involves topical corticosteroids.
- Long-term use of potent topical glucocorticoids can lead to systemic absorption and adverse effects.
Observation:
- A patient with psoriasis self-treated with potent topical glucocorticoids for 15 years.
- The patient developed clinical features consistent with Cushing's syndrome.
Findings:
- Successful withdrawal from topical corticosteroids and treatment with alternative therapies led to the resolution of Cushing's syndrome features.
- Normal cortisol suppression after dexamethasone administration ruled out endogenous hypercortisolism.
Implications:
- This case underscores the potential risks of prolonged, unsupervised use of potent topical corticosteroids.
- Concerns are raised regarding the over-the-counter availability of such powerful medications.