{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:31:40Z","timestamp":1764084700505,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 59-year-old Caucasian gentleman presented with malaise, fatigue and proximal muscle weakness. He had history of long-standing roseate psoriasis treated with topical clobetasol propionate (dermovate). On admission, he had significant postural hypotension, and hypercalcaemia. Endocrinological investigation revealed hypercalcaemia, a serum cortisol of &lt;30 nmol\/l, a flat short synacthen test and undetectable adrenocorticotropic hormone. He was treated with hydrocortisone. The abrupt withdrawal of the topical steroids by the patient precipitated the addisonian crisis. Further enquiry documented inappropriate oral administration of clobetasol for more than 10 years in addition to prescribed topical usage.<\/jats:p>","DOI":"10.1136\/bcr.03.2012.5983","type":"journal-article","created":{"date-parts":[[2012,6,22]],"date-time":"2012-06-22T13:32:10Z","timestamp":1340371930000},"page":"bcr0320125983","source":"Crossref","is-referenced-by-count":7,"title":["Adrenal insufficiency secondary to inappropriate oral administration of topical exogenous steroids presenting with hypercalcaemia"],"prefix":"10.1136","volume":"2012","author":[{"given":"Rahila Sarwar","family":"Bhatti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D","family":"Flynn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,6,22]]},"reference":[{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/S0140-6736(05)17989-6","article-title":"Optimised glucocorticoid therapy: the sharpening of an old spear","volume":"365","author":"Buttgereit","year":"2005","journal-title":"Lancet"},{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2005.01.013"},{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.3","doi-asserted-by":"publisher","DOI":"10.1177\/014107688708000709"},{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.4","unstructured":"Schaefer H Zesch I Stuttgen G . Skin permeability. In: Stuttgen G , eds. Handbuch der Haut und Geschlechtskrankheit Erganzungswerk, B and 1. Berlin: Springer Verlag 1981:632\u20139."},{"issue":"5 Part 2","key":"2025082702043775000_2012.jun21_1.bcr0320125983.5","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1002\/cpt1974165part2873","article-title":"Pharmacokinetics. Pharmacokinetic factors affecting epidermal penetration and percutaneous adsorption.","volume":"16","author":"Riegelman","year":"1974","journal-title":"Clin Pharmacol Ther"},{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1056\/NEJM196510142731601","article-title":"Percutaneous absorption of corticosteroids: systemic effects.","volume":"273","author":"Scoggins","year":"1965","journal-title":"N Engl J Med"},{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5997.619"},{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.8","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/j.1365-2265.1994.tb02540.x","article-title":"Secondary hypoadrenalism presenting with hypercalcaemia.","volume":"41","author":"Vasikaran","year":"1994","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.9","doi-asserted-by":"publisher","DOI":"10.1007\/BF02411297"},{"key":"2025082702043775000_2012.jun21_1.bcr0320125983.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1992.tb00636.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.03.2012.5983","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:04:47Z","timestamp":1756285487000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.03.2012.5983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,6,22]]},"references-count":10,"alternative-id":["10.1136\/bcr.03.2012.5983"],"URL":"https:\/\/doi.org\/10.1136\/bcr.03.2012.5983","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2012,6,22]]}}}