Iatrogenic Cushing Syndrome due to Application of Potent Topical Corticosteroid: A Case Report

Bhusal, Mohan; Aryal, Eliz; Bhattarai, Shristi; Shrestha, Sanju; Rajouria, Alark

doi:10.3126/njdvl.v17i1.23291

Cited by 3 publications

(1 citation statement)

References 7 publications

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“… 25 Bhusal M et al reported a 32-year-old female who developed iatrogenic Cushing's syndrome following the application of clobetasol propionate for disseminated tinea infection. 26 However in our study we did not find any systemic adverse effects.…”

Section: Discussioncontrasting

confidence: 59%

Prevalence of Misuse of Topical Corticosteroid among Dermatology Outpatients

Shrestha¹,

Joshi²,

Bhandari³

2020

J Nepal Med Assoc

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Introduction: Topical corticosteroids misuse has become one of the burning issues in many countries across the globe. They are known to cause a myriad of adverse effects which include local effects commonly and systemic effects rarely. In dermatology practice, one of the common problems we see these days are steroid-induced and steroid aggravated dermatoses. So, this study was done to find the prevalence of misuse of topical corticosteroid among dermatology outpatients. Methods: A descriptive cross-sectional study was done in the outpatient department of dermatology at atertiary care hospital for 18 months. Ethical clearance was obtained from the Institutional Review Committee of NMCTH (Reference no. 029-076/077). Convenient sampling was done. Statistical Package for the Social Sciences (SPSS) version 16 was used to tabulate the data and analyze the results. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 19464 patients, 614 (3.15%) (2.91%-3.39% at 95% Confidence Interval) gave a history of applying steroid containing creams. Among them, 220 (35.8%) belonged to the age group 21-30 years. Dermatophytoses were the skin disease where TCS was most commonly misused followed by melasma in 425 (69.2%) and 115 (18.7%) respectively. Beclomethasone was the steroid preparation that was misused in the maximum number of patients in 271 (44.1%). Some form of adverse effects was seen in 554 (88.6%) patients. Conclusions: Non-prescription sale of topical corticosteroids is the major cause of topical corticosteroids abuse in Nepal. Creating awareness among the prescribers as well as the patients is the current need.

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Section: Discussioncontrasting

confidence: 59%

Prevalence of Misuse of Topical Corticosteroid among Dermatology Outpatients

Shrestha¹,

Joshi²,

Bhandari³

2020

J Nepal Med Assoc

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Recent Insights on Drug Delivery System in Hypertension: From Bench to Market

Sharma

2023

CHYR

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Hypertension is a significant hazardous aspect for several diseases, like cardiovascular disease, kidney failure, and brain disease. Hypertension has become the most lethal condition globally, affecting approximately 1 billion people aged around 30-79 years worldwide. In the year 2022, India was ranked 170th for men and 193rd for women for HTN diagnosis rates among 200 countries worldwide. The main risk factor for cardiac failure and stroke is hypertension. The conventional classes of antihypertensive medications currently available have some side effects. Previously, hypertension has been discussed by various researchers using conventional drug-targeting methods such as ACE inhibitors, aldosterone inhibitors, or renin inhibitors. Recently, novel drug delivery technologies utilizing nanoparticles and new pharmacological classes like ACE2 and APA inhibitors have been studied for the medication of hypertension. In this review, we have covered the epidemiology of hypertension in India, its pathophysiology, medications used in the management of hypertension using nanotechnology, and antihypertensive drugs currently available in the market that are approved and patented. Finally, we have covered how hypertension can be managed with the help of smart devices and artificial intelligence (AI) for improved therapy.

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An Interesting Case of Cushing Syndrome

Singaram,

Nagarajan

2024

International Journal of Innovative Science and Research Techno

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An Interesting Case of Cushing Syndrome A 36 year old female presented to dermatology department with Multiple ulcers present in B/L axilla, B/L inframammary fold and B/L gluteal fold (Left > Right) since 3 months. Patient was referred from dermatology department to General Medicine for opinion on puffiness of face and swelling of legs . Patient had history of topical steroid use for itchy lesions in B/L axilla and inframammary folds 4 months back . H/o weight gain present. (6 kg). H/o puffiness of face and striae present over the abdomen. Patient had no known comorbidities previously. On physical examination patient had moon face ,facial plethora + ,Buffalo hump ,Loss of axillary hair, centripetal obesity , Abdominal striae , Sparse pubic hair , Pallor +. Systemic examination was normal. Investigations revealed new onset diabetes , serum cortisol was low (<0.5 mcg/ml) , serum acth was low (1pg/ml) , HB was low (7.9gm/dl) , total count was elevated (15,600) . Patient was diagnosed to have Iatrogenic (Topical steroid induced) Cushing Syndrome with Steroid induced atrophy and ulceration of skin & subcutaneous tissue leading to secondary fungal and bacterial infection , tinea incognito with secondary bacterial infection , iron deficiency anemia and newly detected Type 2 Diabetes mellitus. Patient was appropiately treated with iv antibiotics (Inj Piperacillin Tazobactum 4.5 g iv thrice daily), daily dressing on other supportive measures along with discontinuation of steroids. Patient improved symptomatically after discontinuing topical steroids, the cushingoid features started decreasing. The ulcers also started to heal. The patient was started on Tab. Hydrocortisone 10mg - 0 – 5mg and was referred for Endocrinologist opinion

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Iatrogenic Cushing Syndrome due to Application of Potent Topical Corticosteroid: A Case Report

Cited by 3 publications

References 7 publications

Prevalence of Misuse of Topical Corticosteroid among Dermatology Outpatients

Prevalence of Misuse of Topical Corticosteroid among Dermatology Outpatients

Recent Insights on Drug Delivery System in Hypertension: From Bench to Market

An Interesting Case of Cushing Syndrome

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