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外用丙酸氯倍他索致儿童银屑病患者发生复杂性医源性库欣综合征:1例报告并文献复习

Complicated iatrogenic Cushing's syndrome induced by topical clobetasol propionate in a child with psoriasis: a case report and review of the literature.

作者信息

Abtahi-Naeini Bahareh, Nasri Peiman, Afshar Kimia, Nouri Nikta

机构信息

Pediatric Dermatology Division of Department of Pediatrics, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Med Case Rep. 2024 Dec 19;18(1):602. doi: 10.1186/s13256-024-04965-7.

Abstract

BACKGROUND

Long-term use of oral or parenteral corticosteroids is the most common cause of hypothalamic-pituitary-adrenal axis suppression and iatrogenic Cushing's syndrome. Still, iatrogenic Cushing's syndrome occurs rarely following the administration of topical corticosteroids.

CASE PRESENTATION

This case study discusses the misuse of a high-potency corticosteroid cream by an Iranian 5-year-old male with plaque-form psoriasis, resulting in Cushingoid symptoms including moon face, buffalo hump, red striae, and weight gain. The child experienced different complications following iatrogenic Cushing's syndrome, such as frequent vomiting and fever, which led to expiration.

CONCLUSION

Proper use and monitoring of topical corticosteroids are emphasized, especially among children. This study also underlines the potential side effects of high-potency corticosteroids and the importance of physicians' and parents' awareness, highlighting the avoidance of excessive topical corticosteroid prescriptions.

摘要

背景

长期口服或胃肠外使用皮质类固醇是下丘脑 - 垂体 - 肾上腺轴抑制和医源性库欣综合征最常见的原因。然而,外用皮质类固醇给药后医源性库欣综合征很少发生。

病例报告

本病例研究讨论了一名患有斑块状银屑病的5岁伊朗男性滥用高效皮质类固醇乳膏,导致出现库欣样症状,包括满月脸、水牛背、红色条纹和体重增加。该儿童在医源性库欣综合征后出现了不同的并发症,如频繁呕吐和发热,最终导致死亡。

结论

强调外用皮质类固醇的正确使用和监测,尤其是在儿童中。本研究还强调了高效皮质类固醇的潜在副作用以及医生和家长意识的重要性,突出了避免过度开具外用皮质类固醇处方的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed14/11658321/61c0353f6625/13256_2024_4965_Fig1_HTML.jpg

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