Introduction: Oral and topical glucocorticoids are widely used in dermatology. They are effective but their side effects are serious, ranging from skin atrophy to life-threatening conditions such as Cushing syndrome and sepsis. The coexistence of Von Zumbusch psoriasis and Cushing syndrome in a pediatric patient is rare.
Case Summary: This is a case of a 15-year old girl who had flares of von Zumbusch psoriasis and developed Cushing syndrome from long use of systemic and super potent topical glucocorticoids. It started as guttate psoriasis spontaneously progressing to von Zumbusch psoriasis. Subsequent episodes of von Zumbusch psoriasis presented as multiple, scattered 1 to 3 pustules on the trunk, forehead, both upper and lower extremities with some coalescing to form lakes of pus and patchy areas of desquamation. These flares were attributed to the withdrawal of systemic glucocorticoids and to upper respiratory and urinary tract infections. She also presented with moon facies and purple striae consistent with Cushing syndrome.
Conclusion: A systemic glucocorticoid should not be used to treat psoriasis because of the significant risk of developing von Zumbusch psoriasis and Cushing syndrome as shown in this case. Significant systemic absorption occurs with extensive use of potent topical glucocorticoids over long periods and represents the same risk posed by systemic glucocorticoids.
von Zumbusch psoriasis, Cushing syndrome, topical and systemic glucocorticoids
Authors: Katrina Carmela M. Belen, MD, DPDS, Jasmin J.Jamora, MD, FPDS , Ma. Cecilia P. Ingente MD, DPDSAbstractBackground: Dermoscopy, a non-invasive diagnostic tool, has been proven to improve the diagnostic accuracy of vascular tumors since it can aid in...
A randomized, double-blind, comparative study on the safety and efficacy of virgin coconut (Cocos nucifera l.) oil against 1% hydrocortisone lotion as an anti-inflammatory and antipruritic preparation for mosquito reactions
Authors: Uy, Veronica S, MD; Gracia B. Teodosio, MD, FPDS; Ma. Teresita G. Gabriel, MD, FPDS; Mary Catherine T. Galang, MD; Mohammad Yoga A. Waskito, MD; Johannes F. Dayrit, MD, FPDS Abstract Background: Virgin coconut oil (VCO) has been reported...
Primary Cutaneous Anaplastic Large Cell Lymphoma (PC-ALCL) is a rare Non-Hodgkin lymphoma (NHL) representing approximately 9% of all cutaneous lymphomas.3 It usually manifests as a slow-growing, solitary tumor which has a tendency to regress spontaneously. However, metastasis is reported in 5-10% of cases.