Hon Kam-Lun Ellis, Burd Andrew
Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
J Dermatolog Treat. 2008;19(4):241-5. doi: 10.1080/09546630701691251.
Many parents purchase topical applications without knowing what they contain, and apply them liberally to their children with dermatological disorders. In one such case, an infant developed fever, diarrhea and a small ulcer near the right labia majora which was treated with a topical cream called '999' containing dexamethasone acetate. The infant subsequently developed extensive necrotizing fasciitis. She required prolonged intravenous antibiotic use and underwent multiple surgical procedures for debridement and reconstruction. Another mother was concerned about therapeutic corticosteroids prescribed to her 11-year old daughter with eczema. She acquired the 999 cream from the Chinese mainland and applied it liberally as an emollient to her daughter's back. When assessed at the clinic, her daughter appeared cushingoid with accelerated growth velocity in BMI and weight but decelerated growth in height. Furthermore, one mother applied a large quantity of 999 on her daughter with mild eczema and another mother applied it on her son with impetigo. None of these mothers knew that they were using potent topical corticosteroids. This report serves to alert the public to avoid applying unknown topical medication on children with skin diseases. The physician caring for patients with skin disease should be aware that even steroidophobic parents might indeed be unknowingly using potent corticosteroids.
许多家长在购买外用制剂时并不清楚其成分，就随意给患有皮肤病的孩子大量涂抹。有这样一个案例，一名婴儿出现发热、腹泻，右大阴唇附近有一个小溃疡，使用了一种名为“999”的含醋酸地塞米松的外用乳膏进行治疗。该婴儿随后患上了广泛的坏死性筋膜炎。她需要长期静脉使用抗生素，并接受了多次清创和重建手术。另一位母亲担心给她11岁患湿疹的女儿开的治疗用皮质类固醇药物。她从中国大陆购得999乳膏，并大量涂抹在女儿背上用作润肤剂。在诊所接受评估时，她的女儿出现了库欣样外观，体重指数和体重增长加速，但身高增长减缓。此外，一位母亲给患有轻度湿疹的女儿大量涂抹999乳膏，另一位母亲给患有脓疱病的儿子涂抹。这些母亲都不知道自己使用的是强效外用皮质类固醇。本报告旨在提醒公众，避免给患有皮肤病的儿童涂抹成分不明的外用药物。治疗皮肤病患者的医生应该意识到，即使是惧怕类固醇的家长也可能在不知不觉中使用强效皮质类固醇。
