Juvenile pustular psoriasis associated with steroid withdrawal syndrome due to topical corticosteroid

Saeki, Hidehisa; Watanabe, Aya; Tada, Yayoi; Kakinuma, Takashi; Komine, Mayumi; Ihn, Hironobu; Asahina, Akihiko; Etoh, Takafumi; Kitanaka, Susumu; Sato, Utako; Kano, Hiroki; Igarashi, Takashi; Tamaki, Kunihiko

doi:10.1111/j.1346-8138.2008.00531.x

Cited by 13 publications

(11 citation statements)

References 11 publications

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“…The previous reports summary of Iatrogenic Cushing syndrome due to topical steroid in children and adult were shown in Table 1A [1][2][3][4][5][6][7][8][9][10][11][12][13][14] and B [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], respectively. Most affected cases in children group (Table 1A) were an infant (86%) with diaper dermatitis, and the other primary diseases (27%) were Psoriasis, burn, skin dryness.…”

Section: Introductionmentioning

confidence: 99%

Exogenous Cushing’s syndrome due to topical corticosteroid application: case report and review literature

Tempark

Phatarakijnirund

Chatproedprai

et al. 2010

Endocr

108

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Prolonged use of topical corticosteroids causes systemic adverse effects including Cushing's syndrome and hypothalamic-pituitary-adrenal (HPA) axis suppression, which is less common than that of the oral or parenteral route. At least 43 cases with iatrogenic Cushing syndrome from very potent topical steroid usage (Clobetasol) in children and adult have been published over the last 35 years particularly in developing countries. In children group (n = 22), most are infants with diaper dermatitis and two cases who had started topical application at a very early age and died from severe disseminated CMV infection. For the adult group (n = 21), the most common purpose of steroid use was for treatment of Psoriasis. The recovery period of HPA axis suppression was 3.49 ± 2.92 and 3.84 ± 2.51 months in children and adult, respectively. We report on an 8-month-old female infant who developed Cushing's syndrome and adrenal insufficiency after diaper dermatitis treatment through the misuse of Clobetasol without doctor's prescription. Physiologic dose of hydrocortisone was prescribed to prevent an adrenal crisis for 3 months and discontinued when HPA axis recovery was confirmed by normal morning cortisol and ACTH levels.

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Section: Introductionmentioning

confidence: 99%

Exogenous Cushing’s syndrome due to topical corticosteroid application: case report and review literature

Tempark

Phatarakijnirund

Chatproedprai

et al. 2010

Endocr

108

View full text Add to dashboard Cite

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“…In psoriasis, systemic effects of potent topical steroids such as hypothalamic-pituitary-adrenal axis suppression, tachyphylaxis and pustular flares have been reported in adults. 1 Topical corticosteroids may have contributed to the pustular flares seen in our patient. 1 Studies have shown that 2 g per day of clobetasol propionate 0.05% cream can reduce morning blood cortisol level after only a few days.…”

mentioning

confidence: 75%

“…1 Topical corticosteroids may have contributed to the pustular flares seen in our patient. 1 Studies have shown that 2 g per day of clobetasol propionate 0.05% cream can reduce morning blood cortisol level after only a few days. 2,3 Cases of hypercalcaemia secondary to treatment with calcipotriol have been reported.…”

mentioning

confidence: 75%

Iatrogenic adrenal insufficiency associated with calcipotriol–betamethasone topical combination in psoriasis

Giannitelli

Maza

Lahfa

et al. 2010

Clinical and Experimental Dermatology

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“…All 1199 patients with prior immunosuppressants treatment experienced mean 110% (range, from 55% to 240%) worsening of PASI score relative to baseline value during the study (Figure 3), which was the immunosuppressants withdrawal syndrome [33–37] of psoriasis flare. At the end point, 14 (7.4%), 9 (4.5%), 1 (0.6%), 16 (8.5%), 1 (0.6%), and 1 (0.2%) psoriasis patients with comorbidities of hypertension, hyperlipidaemia, asthma, arthritis, hepatitis B, and eczema completed study and achieved Physician Global Assessment (PGA) score of “minimal” at month 60.…”

Section: Resultsmentioning

confidence: 99%

A Nonimmunosuppressant Approach on Asia Psoriasis Subjects: 5-Year Followup and 11-Year Data Analysis

Yuqi¹

2012

Dermatology Research and Practice

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Mono- or combine immunosuppressants are commonly used for psoriasis; however the side effect caused by potent systemic immunosuppressants frequently incurred; moreover the inflammation flares up shortly after immunosuppressants are discontinued. An alternative nonimmunosuppressive therapy was introduced to psoriasis subjects. A retrospective observational study consisted of 1583 psoriasis patients who were treated with Herose Psoria capsule 1440 mg three times daily at two clinical centres, one in China, the other in Singapore, from 1 January 2000 to 1 January 2011. Psoriasis lesion evolution was photographed at monthly visit, and efficacy and safety were assessed using psoriasis area severity index PASI score grading, renal and liver function testing, and adverse event reporting and supplemented by information obtained during targeted telephone interviews. The effectiveness of Herose on psoriasis was inversely associated to prior immunosuppressants exposure (r = 0.9154), significant improvements occurred in non-immunosuppressants subjects, and complete clearance was achieved in 8 months (87.5%, 14 of 16); the wavelike evolution of psoriatic lesion appeared in prior immunosuppressants subjects.

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Juvenile pustular psoriasis associated with steroid withdrawal syndrome due to topical corticosteroid

Cited by 13 publications

References 11 publications

Exogenous Cushing’s syndrome due to topical corticosteroid application: case report and review literature

Exogenous Cushing’s syndrome due to topical corticosteroid application: case report and review literature

Iatrogenic adrenal insufficiency associated with calcipotriol–betamethasone topical combination in psoriasis

A Nonimmunosuppressant Approach on Asia Psoriasis Subjects: 5-Year Followup and 11-Year Data Analysis

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