Sachdeva Soumya, Arora Pooja, Kulhari Anita, Sardana Kabir
Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, Delhi, India.
Dermatol Ther. 2020 Jul;33(4):e13514. doi: 10.1111/dth.13514. Epub 2020 Jun 12.
Psoriasis vulgaris is a chronic inflammatory disorder that affects the skin and joints. Mild disease is treated with topical corticosteroids (CS) which forms the first line of treatment for localized disease. While it is well established that prolonged use of oral or parenteral corticosteroids can lead to iatrogenic Cushing's syndrome and suppression of hypothalamic pituitary axis; development of these complications secondary to use of topical CS is rarely described. Since steroids have anti-inflammatory properties, their prolonged use can lead to increased susceptibility to develop bacterial and fungal infections. We hereby report a 11-year-old female with psoriasis who presented with septicaemia and features of iatrogenic Cushing's syndrome due to treatment with topical corticosteroids for 2 years. Presentation of ICS as septicemia due to topical steroid use in this age group or in a psoriatic patient has not been described in the literature so far. Patient also developed hypertension and osteopenia, which are known adverse effects of corticosteroids; but occur rarely due to topical corticosteroids.
寻常型银屑病是一种影响皮肤和关节的慢性炎症性疾病。轻度疾病采用外用糖皮质激素（CS）治疗，这是局限性疾病的一线治疗方法。虽然长期使用口服或胃肠外糖皮质激素会导致医源性库欣综合征和下丘脑 - 垂体轴抑制已得到充分证实，但很少描述因使用外用CS继发这些并发症的情况。由于类固醇具有抗炎特性，长期使用会导致易患细菌和真菌感染。我们在此报告一名11岁的银屑病女性患者，因外用糖皮质激素治疗2年出现败血症和医源性库欣综合征的特征。迄今为止，文献中尚未描述在该年龄组或银屑病患者中因使用外用类固醇导致败血症形式的医源性库欣综合征。患者还出现了高血压和骨质减少，这是糖皮质激素已知的不良反应，但外用糖皮质激素很少引起。
