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KMID : 0363220070450090947
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Korean Journal of Dermatology
2007 Volume.45 No. 9 p.947 ~ p.950
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Suspected Case of Iatrogenic Cushing Syndrome Due to Topical Steroid
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Kim Hyun-Dai
Yoon Nyung-Hoon
Park Seok-Don
Won Tai-Hyok
Seo Phil-Seung
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Abstract
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Chronic exogenous steroid therapy can result in hypothalamic-pituitary-adrenal axis dysfunction; this usually results from systemic steroid therapy, and is rarely associated with topical steroid therapy. We report a case of suspected iatrogenic Cushing syndrome that developed after the treatment of annular pustular psoriasis. The patient applied clobetasol-17-propionate cream (Betabate(R)) 15~30 g daily, for 4 months, without a dermatologist’s prescription. After 4 months of application, the following symptoms developed; a moon face; facial flushing; hypertrichosis; central obesity; purple striae; and multiple erythematous scaly annular patches. The development of Cushing syndrome from exogenous corticosteroid treatment was supported by the typical clinical manifestations and the low basal state of the blood cortisol level, which was perhaps due to secondary suppression of the hypothalamic pituitary-adrenal axis. Steroid-containing drugs, especially during childhood, should be used with caution and monitored carefully.
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KEYWORD
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Annular pustular psoriasis, Iatrogenic Cushing syndrome, Topical steroid
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