Appearance of systemic side effects following topical treatment with corticosteroids is well recognized. Owing to widespread use of corticosteroids for topical application, studies are needed to determine the upper limit of treatment dose by which systemic side effects can be avoided. It has previously been shown that topical treatment with clobetasol propionate (Dermovate [Britain]; no comparable US product) in doses of 18 to 268 g/wk produced abnormal cortisol levels after cosyntropin injection. Although most pronounced at higher doses, adrenal function in some cases also was impaired at doses less than 50 g/wk.1 In this study we assessed hypothalamic-pituitary-adrenocortical (HPA) integrity during a threeweek period of topical treatment with another widely used corticosteroid, betamethasone dipropionate cream. The results showed that treatment with 50 g/wk for three weeks without occlusion did not affect HPA function.
Subjects and Methods
Seventeen patients (eight female, nine male), of whom eight had severe universal psoriasis
Reymann F, Kehlet H. Hypothalamic-Pituitary-Adrenocortical FunctionAssociation With Topical Application of Betamethasone Dipropionate. Arch Dermatol. 1979;115(3):362–363. doi:10.1001/archderm.1979.04010030064026