Iatrogenic Cushing Syndrome Caused by Long-term Use of High Potency Topical Steroid

Iatrogenic Cushing syndrome is a well-known adverse reaction of steroids, but there are few reports of this condition caused by topical agents. Although systemic side effects from topical steroids are rare, lack of physician awareness and patient guidance can lead to a risk of adverse reaction of steroids. A 12-year-old girl had been treated with betamethasone butyrate propionate as atopic dermatitis from age 6. However, her family doctor continued to prescribe without explaining how to use and the risks of side effects. As a result of continuing to apply 15 grams of it all over her body every week, except in summer when skin symptoms were mild, she developed Cushing syndrome and was referred to our hospital after short stature was reviled at school physical examination. Although MRI scan indicated possible anterior pituitary suppression, there were no suppressive findings in the hormone loading test. With appropriate topical steroids, Cushing symptoms have generally improved, and the decline in the growth rate of her height has stopped. Thus, topical corticosteroids can cause systemic side effects in children. We should avoid inappropriate topical steroids use and properly instruct patients and their families about the use of the drugs and the side effects of treatment.