STUDIES ON ADRENOCORTICAL FUNCTION IN TEN CHILDREN WITH SEVERE ATOPIC DERMATITIS

Abstract

We examined adrenocortical function in ten children with severe atopic dermatitis who were treated with topical corticosteroid preparations for an average of 4 years and 11 months.The ACTH stimulation test was performed with an intravenous drip of ACTH (0.003mg/kg in one hour). Observation was carried out 2 hours later. A rising incline index in cortisol or 11-OHCS per hour was used.In children with atopic dermatitis, the rising incline index was significantly smaller than in control patients who did not receive prolonged topical corticosteroid therapy (p<0.01). No differences in basal cortisol or 11-OHCS levels were noted. For 4 patients, their heights were less than -2 SD.The results suggest that topical corticosteroid therapy for atopic dermatitis may cause adrenal suppression and also stunted growth and a permanent short stature. The mode of topical therapy shoud be changed to alternating or daily administration in the morning in patients with insufficient responsiveness to ACTH stimulation.