A prolonged use of topical corticosteroids can result in Cushing syndrome, though this is less common than with oral or parenteral steroids. Most pediatric cases were due to application of topical steroids for diaper dermatitis. Adverse cardiovascular effects can occur in Cushing syndrome with significant long-term morbidity and mortality, though so far there have been no reports of cardiovascular complications due to excessive usage of topical steroids. We report a 2.5-month-old boy who rapidly developed severe Cushing syndrome induced by the misuse of topical clobetasol, a very potent steroid, without a doctor's prescription as a diaper rash cream, and developed moderate left ventricular hypertrophy and pericardial effusion.

Tempark T, Phatarakijnirund V, Chatproedprai S, Watcharasndhu S, Supornsilchai V, Wananukul S: Exogenous Cushing's syndrome due to topical corticosteroid application. Endocrine 2010;38:328-334.
Guven A, Karadeniz S, Aydin O, Akbalik M, Aydin M: Fatal disseminated cytomegalovirus infection in an infant with Cushing's syndrome caused by topical steroid. Horm Res 2005;64:35-38.
Guven A, Gulumser O, Ozgen T: Cushing's syndrome and adrenocortical insufficiency caused by topical steroids: misuse or abuse? J Pediatr Endocrinol Metab 2007;20:1173-1182.
Working Group Report from the National High Blood Pressure Education Program: Update on the task force report (1987) on high blood pressure in children and adolescents. Pediatrics 1996;98:649-658.
Tadicherla S, Ross K, Shenefelt PD, Fenske NA: Topical corticosteroids in dermatology. J Drugs Dermatol 2009;8:1093.
British National Formulary Topical Corticosteroid Preparation Potencies 2014; Section 13.4.
Plotz CM, Knowlton AI, Ragan C: The natural history of Cushing's syndrome. Am J Med 1952;13:597.
Pirpiris M, Sudhir K, Yeung S, Jennings G, Whitworth JA: Pressor responsiveness in corticosteroid-induced hypertension in humans. Hypertension 1992;19:567.
Takagi S, Tanabe A, Tsuiki M, Naruse M, Takano K: Hypokalemia, diabetes mellitus, and hypercortisolemia are the major contributing factors to cardiac dysfunction in adrenal Cushing's syndrome. Endocr J 2009;56:1009.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.