Skin Complications of Cortisone and Acth Therapy

Abstract

amount of the drug she remained comfortable and free of pain in the extremities. However, diarrhea developed. When treat¬ ment with the drug was discontinued, pain in the legs returned and the diarrhea stopped. When the drug was again given the diarrhea returned and the pain in the legs stopped. She chose to have the diarrhea rather than the pain. Twelve days after admission she was transferred to an orthopedic hospital completely relaxed and free of pain. At the termination of her pregnancy, in October, she delivered a normal baby boy. COMMENT At the present time there is no form of treatment in acute poliomyelitis that limits the spread of virus in the central nervous system or alters its effect on the nerve cells. Many patients recovered completely with¬ out treatment hut others, despite heroic measures, suffer extensive paralyses.

Changes in mechanical properties, thermal stability, reducible cross-links and glycosyl-lysines in rat skin induced by corticosteroid treatment

“…Atrophie striae (Behrman & Goodman 1950;Epstein & Epstein 1963) have been reported after long-term corticosteroid therapy and have been attributed to loss of connec¬ tive tissue fibres.…”

“…Undesired side ef¬ fects, however, are common. With regard to skin there are numerous reports on skin thinning, atrophy and striae (Behrman & Goodman 1950;Shuster 1967;David et al 1970). …”

Steroid-induced atrophy in an animal and human model

“…This response in the animal was used to assess the atrophic potential in a variety of standard formulations. The same compounds were applied to human skin and the changes in thickness measured.Patterns of response and the rank order of thinning obtained from the animal model were found to parallel closely the human results.Atrophic skin changes have long been recognized in association with adrenocortical hormone excess (Albright, Parsons and Bloomberg 1941;Behrman & Goodman, 1950).Similar changes follow the topical application of corticosteroids. These compounds had been in clinical use for many years before this effect was noticed (Epstein, Epstein & Epstein, 1963; Sneddon 1968).…”

Diseases of Bones and Joints

“…(223) reported the presence of perforated duodenal ulcer associated with ACTH therapy. Behrman (224) reported four patients treated with ACTH and cortisone who developed skin manifestations of hyperpigmentation, acne, hirsuteness, rounded face, striae-atrophicae, delayed wound-healing, and flattening of keloidal scars.…”