Iatrogenic Adrenal Failure Due to Corticosteroid-Treated Psoriasis: Pediatric Case Report

Maja Tankoska, D. Jakimovski, A. Stamatova, A. Starova, N. Biljanovska, Z. Guchev, M. Krstevska-Konstantinova
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Abstract

Abstract Plethora of pediatric autoimmune, dermatological, neurological and atopic disease require chronic administration of steroid medication. Long-term use of corticosterioids can result in both local (atrophy of the skin, hypertrichosis, and telangiectasia) and systemic side effects (hypothalamic-pituitary-adrenal (HPA) axis disturbance, risk of infections). We report a case of 3.5-year-old boy, who developed Cushing syndrome and secondary adrenal insufficiency after corticosteroid cream maltreatment of his psoriasis. After initial hospitalization and recovery, physiological doses of hydrocortisone were used to normalize the HPA axis. In order to prevent Cushing syndrome development, adrenal insufficiencies, and secondary infections, precaution in use of steroid therapy in early childhood must be exercised.
皮质类固醇治疗银屑病致医源性肾上腺功能衰竭:儿科病例报告
摘要儿童自身免疫性、皮肤病、神经系统和特应性疾病需要长期服用类固醇药物。长期使用皮质类固醇会导致局部(皮肤萎缩、多毛症和毛细血管扩张)和全身副作用(下丘脑-垂体-肾上腺(HPA)轴紊乱、感染风险)。我们报告了一个3.5岁男孩的病例,他在滥用皮质类固醇乳膏治疗银屑病后出现库欣综合征和继发性肾上腺功能不全。在初次住院和康复后,使用生理剂量的氢化可的松使HPA轴正常化。为了预防库欣综合征的发展、肾上腺功能不足和继发感染,必须在儿童早期使用类固醇治疗。
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