Cushing’s syndrome caused by topical steroid for treatment of diaper dermatitis: case report

Year 2018, , 91 - 94, 01.01.2018

Sefer Üstebay , Döndü Ülker Üstebay

https://doi.org/10.5505/kjms.2017.64935

Abstract

Diaper dermatitis is a common condition in childhood and topical steroid cream is used in the treatment. Iatrogenic Cushing's syndrome can be seen as a result of hypothalamic-pituitary-adrenal axis suppression due to long-term use and misuse of such steroids. We present a case of iatrogenic Cushing's syndrome in an eightmonth-old infant after the use of clobetasol 17-propionate 0.05% cream for about six months for diaper dermatitis. Steroid cream use should be queried in the history of the patients with Cushing's syndrome symptoms in infancy in particular and the family should be informed on the possible side effects of these creams and the necessary form and duration of use in detail.

Keywords

İatrogenic cushing’s syndrome, topical corticosteroid, diaper dermatitis

Diaper Dermatit Nedeniyle Steroid Kullanımına Bağlı Gelişen Cushing Sendromu: Olgu Sunumu

Abstract

Diaper dermatit çocukluk döneminde sık görülen ve tedavisinde topikal steroidli kremlerin kullanıldığı bir durumdur. Bu steroidlerin uzun süreli ve yanlış kullanımına bağlı olarak hipotalamo-pituiter-adrenal aks supresyonu sonucu iyatrojenik cushing sendromu görülebilmektedir. Bu çalışmada diaper dermatit nedeniyle yaklaşık altı ay klobetasol 17-propionate %0.05 krem kullanan sekiz aylık süt çocuğunda görülen iyatrojenik cushing sendromu olgusu sunulmuştur. Özellikle süt çocukluğu döneminde cushing sendromu bulguları olan hastalarda öyküde, kullanılan steroidli kremler sorgulanmalı, aileye bu kremlerin olası yan etkileri, kullanım şekli ve süresi konusunda detaylı bilgi verilmelidir.

Keywords

İatrojenik cushing sendromu, topikal kortikosteroid, diaper dermatit

References

• 1- Kandemir N. Adrenal Hastalıklar. Günöz H, Öcal G, Yordam N, Kurtoğlu S (Editörler). Pediatrik Endokrinoloji, Pediatrik Endokrinol Oksol Dern Yay 1,361-414.
• 2-Kumar S, Singh Rj, ReedAm,et al. Cushings syndrome after intra-articular and intradermal administration of triamcoloneacetonide in three pediatric patients.Pediatrics 2004;113:1820-4.
• 3- Sıklar Z, Bostancı I, Atlı Ö, et al. An infantile Cushing syndrome due to misuse of topical steroid. Pediatric Dermatol 2004; 21:56-63.
• 4-Ozon A, Cetinkaya S, Alikasifoglu A, et al. Inappropriate use of potent topical glucocorticoids in infants. J Pediatr Endocrinol Met 2007;20:219-225.
• 5-Migeon CJ. Adrenal cortex. In: Lifshitz F (ed). Pediatric Endocrinology (3rd ed.,revisedand expanded). New York: Markel Inc, 2003: 147-74.
• 6- Magiakou MA, Mastorakos G, OldfieldEH, et al. Cushing’s syndrome in children and adolescents. Presentation, diagnosis and therapy. New Eng J Med 1994; 331: 629-39.
• 7-Chamberlin P, Meyer WJ. Management of pituiary-adrenal Suppression secondary to to corticosteroid therapy. Pediatrics 1981;67: 245-51.
• 8- Park YJ, Park KS, Kim JH, et al. Reproductibility of the cortisol response to stimulation with the low dose (1 mg) of ACTH. Clin Endocrinol 1999; 51: 153-8.