{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T15:31:02Z","timestamp":1782228662419,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Glucocorticoids suppress the hypothalamic\u2013pituitary\u2013adrenal axis, which may lead to glucocorticoid\u2010induced adrenal insufficiency. The study aimed to investigate the prevalence of this state in patients with oral lichen planus treated with topical clobetasol propionate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, 30 patients with oral lichen planus receiving long\u2010term (&gt;6\u2009weeks) clobetasol propionate gel 0.025% were invited to participate. Adrenal function was assessed by measuring morning plasma cortisol after a 48\u2010h withdrawal of clobetasol treatment. In patients with plasma cortisol &lt;280\u2009nmol\/L, a cosyntropin stimulation test was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010seven patients were included. Twenty\u2010one (78%) patients presented with plasma cortisol \u2265280\u2009nmol\/L (range 280\u2013570\u2009nmol\/L), and six (22%) &lt;280\u2009nmol\/L (range 13\u2013260\u2009nmol\/L). Five of these six patients underwent cosyntropin stimulation that revealed severe adrenal insufficiency in two patients (cortisol peak 150\u2009nmol\/L and 210\u2009nmol\/L) and mild adrenal insufficiency in three patients (cortisol peak 350\u2013388\u2009nmol\/L).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, approximately 20% of patients receiving intermittent topical glucocorticoid treatment for oral lichen planus had glucocorticoid\u2010induced adrenal insufficiency. It is essential for clinicians to be aware of this risk and to inform patients about the potential need for glucocorticoid stress doses during intercurrent illness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.14588","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T10:40:01Z","timestamp":1682592001000},"page":"1304-1312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Topical clobetasol treatment for oral lichen planus can cause adrenal insufficiency"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6010-9599","authenticated-orcid":false,"given":"Margret J.","family":"Einarsdottir","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Clinical Nutrition Institute of Medicine at Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Endocrinology Sahlgrenska 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