Table 2.
Descriptions and comparison of cases
| Study | Patient age/sex | TCS | Duration of use | Clinical manifestations of Cushing’s syndrome | Complications and outcomes | ACTH (pg/mL)a |
|---|---|---|---|---|---|---|
| Ref. [16] | 13 years/female | Betamethasone | 9 weeks | Cushingoid face, developed buttocks and thighs striae | Six weeks after discontinuing TCS, the daily fluctuations in plasma cortisol levels returned to normal | < 1 |
| Ref. [17] | NA | Clobetasol propionate | 4 months | Moon face, facial flushing, hypertrichosis, central obesity, purple striae, and multiple erythematous scaly annular patches | NA | NA |
| Ref. [5] | 11 years/female | NA | 2 years | Weight gain of 20 kg in the last 2 years, flushed and typical moon facies, erythroderma, truncal obesity with striae, and hypertrichosis with a neck hump | Gradual resolution of lesions and 75% reduction in psoriasis area and severity index at 4 weeks of treatment | 10.3 |
| Ref. [18] | 8 month/female | Clobetasol propionate | 2 months | Excessive weight gain, truncal obesity, moon face, hirsutism, buffalo hump, erythematous papules at the skin fold areas, monomorphic erythematous pustules at the upper back without comedone | Her weight was decreasing, while her height was increasing to her normal percentile. Serum morning cortisol and ACTH returned to normal ranges | < 10 |
| Ref [19] | 19 months/male | Aristobet-N (betamethasone–neomycin) nasal drop | 2 months | Obesity, moon-like face, excessive hair on the forehead, back and pubis. No axillary hair. Weight was 17.5 kg (95th percentile) and within 1 week increased to 18.0 kg | 3 months after weaning off, the steroid was within normal limits | NA |
| Ref. [19] | 9 months/male | Aristobed-N (betamethasone-neomycin) nasal drop | 7 weeks | Round face, a height of 62 cm (below the 5th percentile), and a body mass index of 36.7 kg/m2 (above the 95th percentile) | Initially had a low serum cortisol level of 1.69 nmol/L, which increased to 128 nmol/L one month after starting steroid withdrawal. Bone age assessment was consistent with the child’s chronological age | NA |
| Ref. [20] | 9 years/female | Betamethasone sodium phosphate eye drops (0.1% solution) | 6 months | Weight gain, truncal obesity, buffalo hump, moon face, femoral skin striae | After 6 months of methotrexate treatment, morning serum cortisol and plasma ACTH levels were 10.1 µg/dL and 42.6 pg/mL, respectively | < 2 |
| Ref. [21] | 6 years/female | Clobetasol propionate | 8 weeks | Moon facies and mild facial plethora, Tanner stage 1 for breast and pubic hair development, 1.6 kg weight gain | The patient’s facial appearance returned to normal after the topical steroid taper | NA |
| Ref. [22] | 3.5 months/female | Clobetasol propionate | 2 months | Face puffing and generalized edema | ACTH and cortisol levels were normalized. Facial puffiness and edema improved | 0.7 |
| Ref [7] | 6 months/male | Clobetasol propionate | 4 weeks | Dystrophy presented with a Cushingoid face and scratch marks on the abdomen | NA | 1.3 |
| Ref. [7] | 2 years/female | Dexamethasone eye drop | Few weeks | Short stature, dystrophy, low body mass index, growth hormone deficiency, bone mineralization deficiency, nephropathy, hepatopathy, anemia, and chronic inflammation | 8 weeks later the patient showed catch-up growth | < 7 |
| Ref. [8] | 6 months/male | Betamethasone | 2–3 months | ICS symptoms, hirsutism, a Cushingoid face, and a buffalo hump. Hyperpigmentation around the diaper region | Full recovery | NA |
| This case report | 5 years/male | Clobetasol propionate | 1 year | Excess weight, abdominal obesity, generalized edema, moon face, and red striae on the abdominal area | Complications included frequent vomiting, activated psoriatic lesions, and fever. Treatment led to improvement in Cushingoid symptoms and psoriatic lesions | NA |
aACTH normal range: 10 to 50 (pg/mL)
NA, not available