Pituitary-Adrenal Function Following Topical Triamcinolone Acetonide and Occlusion

Abstract

This study was undertaken to investigate the possible pituitary-adrenal suppressive effects of triamcinolone acetonide under occlusive dressings in six psoriatic patients. Forty-five grams of a cream containing 0.1% triamcinolone acetonide was applied daily to the psoriatic lesions of four patients and covered with an occlusive dressing. Two patients received daily applications of 45 gm of 0.01% triamcinolone acetonide cream and occlusive dressings. The four patients who received the 0.1% triamcinolone acetonide applications showed a marked decrease in the 24-hour urinary 17-hydroxycorticosteroids and no significant response to intravenous metyrapone testing. The two patients who were treated with 0.01% triamcinolone acetonide also showed a significant decrease in 24-hour urinary 17-hydroxycorticosteroids, but a partial response to metyrapone testing. Percutaneous absorption of as little as 1 to 2 mg of triamcinolone acetonide may affect pituitary-adrenal function.