{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T21:18:24Z","timestamp":1785705504341,"version":"3.56.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Iatrogenic Cushing\u2019s syndrome (ICS) is frequently observed as a side effect of long-term steroid treatment. While it is most commonly linked to the administration of oral steroids, rare instances have been reported following the inadvertent use of topical steroids, which can lead to severe clinical consequences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case summary<\/jats:title><jats:p>This case report details the case of a psoriasis patient who exhibited Cushing-like symptoms, such as central obesity, violaceous striae, moon face, and hypertension, following the long-term use of a so-called \u201cherbal cream\u201d containing clobetasol propionate. Laboratory investigations revealed hypokalemia, a disrupted cortisol circadian rhythm, and suppressed plasma ACTH levels. Additionally, bone mineral density analysis indicated a reduction in bone density.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case underscores the critical need for clinicians to remain vigilant about the potential systemic adverse effects of topical glucocorticoids, particularly in psoriasis patients, where even minimal concentrations of clobetasol propionate can precipitate ICS. Furthermore, identifying the source of exogenous glucocorticoids in ICS necessitates a thorough review of the patient\u2019s medication history, encompassing over-the-counter drugs and supplements. It is important that medication use be guided by specialist consultation and rigorous monitoring, rather than unsupervised self-medication.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1591869","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:26:56Z","timestamp":1759123616000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Iatrogenic Cushing\u2019s syndrome induced by topical steroid abuse in a patient with psoriasis: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Jianwei","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunnuo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiying","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref1","article-title":"Cushing 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Indian moderate-to-severe psoriasis patients: phase-2a, randomized 3-arm study","volume":"11","author":"Sidgiddi","year":"2021","journal-title":"Dermatol Ther"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1358\/dot.2008.44.7.1122221","article-title":"Clobetasol propionate\u2014where, when, why?","volume":"44","author":"Pels","year":"2008","journal-title":"Drugs Today"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.jaad.2008.06.041","article-title":"Treatment of intertriginous psoriasis: from the Medical Board of the National Psoriasis Foundation","volume":"60","author":"Kalb","year":"2009","journal-title":"J Am Acad Dermatol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"416","DOI":"10.4103\/2229-5178.142483","article-title":"Side-effects of topical steroids: a long overdue revisit","volume":"5","author":"Coondoo","year":"2014","journal-title":"Indian Dermatol Online J"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.therap.2019.03.005","article-title":"Adult iatrogenic Cushing\u2019s syndrome induced by topical skin corticosteroid misuse","volume":"74","author":"Negrini","year":"2019","journal-title":"Therapies"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1136\/bmj.4.5997.619","article-title":"Effect on adrenal function of topically applied clobetasol propionate (dermovate)","volume":"4","author":"Allenby","year":"1975","journal-title":"Br Med J"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1177\/014107688708000709","article-title":"Adrenal suppression following low-dose topical clobetasol propionate","volume":"80","author":"Ohman","year":"1987","journal-title":"J R Soc Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/j.1365-2230.1983.tb01758.x","article-title":"Investigation of the pharmacokinetics of clobetasol 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