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KMID : 1148020130380010042
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조선대학교의대논문집
2013 Volume.38 No. 1 p.42 ~ p.45
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A Case of Rapidly Developing Iatrogenic Cushing’s Syndrome after Short-term Application of Topical Agent of Betamethasone Diproprinate/Clotrimazole Combination Ointment
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So Jung-Hae
Kim Seok-Son
Choi Young-Min
Bae Hak-Yeon
Kim Sang-Yong
Kim Jin-Hwa
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Abstract
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Demacort® is mixture of betamethasone (high-potency corticosteroid) and clotrimazole (antifungal agent), an inhibitor ofCYP3A4, which can inhibit the metabolism of betamethasone. Interaction of these drugs may result in decreased clearanceof betamethasone and increased risk for adverse events such as iatrogenic Cushing’s syndrome. A 26-year-old female wasadmitted to the hospital due to rapid weight gain after application of Demacort®. During a period of one month, she showedweight gain of 30 kg and developed several Cushingoid appearances. The result of an overnight dexamethasone suppressiontest was negative, thus, endogenous Cushing’s syndrome was ruled out. A negative cortisol response was observed for therapid ACTH stimulation test; therefore, we made a diagnosis of iatrogenic Cushing’s syndrome combined with additionalsecondary adrenal insufficiency.
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KEYWORD
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Glucocorticoid hypersensitivity, Iatrogenic cushing’s syndrome, Topical glucocorticoid
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