Topical corticosteroid-induced iatrogenic cushing syndrome in an infant; a case report with literature review

• Published in: Annals of medicine and surgery Vol. 71; p. 102978
• Main Authors: Ahmed, Soran M., Ahmed, Shaho F., Othman, Snur, Abdulla, Berwn A., Mohammed, Shvan H., Salih, Abdulwahid M., Kakamad, Fahmi H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2021; Elsevier
• Subjects: Case Report; Cushing syndrome; Iatrogenic; Infant; Topical corticosteroid; Infant; Iatrogenic; Topical corticosteroid; Cushing syndrome
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.102978

Cushing syndrome (CS) is an endocrinological abnormality that results from a high level of glucocorticoids in the blood. Iatrogenic CS due to the overuse of topical corticosteroids is rarely reported. The current study aims to present a rare case of topical corticosteroid induced iatrogenic CS in an infant. A 4-month-old female infant presented with an insidious onset of face puffiness that progressed over a 2-month period. The mother reported to have used a cream containing Betamethasone corticosteroid 5–8 times a day for a duration of 3 months to treat diaper dermatitis. Laboratory findings revealed low levels of adrenocorticotrophic hormone (ACTH) and serum. Abdominal ultrasound showed normal adrenal glands. The topical corticosteroid was halted and physiologic topical hydrocortisone doses were administered. Infants are more likely to acquire topical corticosteroid induced iatrogenic CS due to their thin and absorptive skin, higher body surface area, and the high prevalence of conditions that necessitates the use of these medications. Most iatrogenic CS cases following topical steroid application have been reported in infants with diaper dermatitis that are most commonly treated with Clobetasol and Bethamethasone. Infants are susceptible to develop CS due to topical corticosteroid overuse. Hence, physicians need to consider this in infantile CS cases, and take appropriate measures to avoid their occurrence. •Cushing syndrome is an abnormality resulting from high level of blood glucocorticoids.•Iatrogenic Cushing syndrome due to the overuse of topical corticosteroids is rarely reported.•This report presents a case of topical corticosteroid induced iatrogenic Cushing syndrome in an infant.