Unusual cause of Cushing’s syndrome in a child

Abstract

Local application of potent glucocorticoid (GC) ointments/lotions/creams for a prolonged period and in high doses has been reported to cause Cushing’s syndrome (CS) in young children [1,2]. We describe a case of 14 months old male baby who was brought with the concern of excessive hair growth over his face from the previous two months. His parents had been applying clobetasol propionate (CP) ointment, approximately 20 gm (0.05% w/w) per day, over his buttocks since the age of 1 month for diaper rash. On examination, he had diffuse villous hair over his face/forehead and thin skin (Figure). BP 87/46 mmHg (50th percentile). His height was 68 cm (SDS -3), and his weight was 17 kg (SDS +3.3). His 8 am cortisol was 0.04 ug/dl, and ACTH was 3.8 pg/ml.