1988 Volume 2 Issue 2 Pages 50-56
We examined adrenocortical function in ten children with severe atopic dermatitis who were treated with topical corticosteroid preparations for an average of 4 years and 11 months.
The ACTH stimulation test was performed with an intravenous drip of ACTH (0.003mg/kg in one hour). Observation was carried out 2 hours later. A rising incline index in cortisol or 11-OHCS per hour was used.
In children with atopic dermatitis, the rising incline index was significantly smaller than in control patients who did not receive prolonged topical corticosteroid therapy (p<0.01). No differences in basal cortisol or 11-OHCS levels were noted. For 4 patients, their heights were less than -2 SD.
The results suggest that topical corticosteroid therapy for atopic dermatitis may cause adrenal suppression and also stunted growth and a permanent short stature. The mode of topical therapy shoud be changed to alternating or daily administration in the morning in patients with insufficient responsiveness to ACTH stimulation.
