Abstract
We compared GCMS with plasma and urinary free cortisol concentrations to determine indices of HPAS in urine samples obtained from subjects treated with topical steroids. The subjects were 37 males requiring treatment for severe psoriasis valgaris. Two topical ointments betamethasone diproprionate (A) and Clobetasol 17-proprionate (B) were studied employing a double blind, randomized, parallel matrix. Over a 12 weeks we compared standard endocrine function tests (plasma and urinary free oortisol) with GCMS. Twenty-four hour urines and a.m. plasma were obtained prior to, during and after the treatment; treatment efficacy was evaluated by one of the investigators in each phase.
A dramatic and similar treatment response was observed with both agents and laboratory indices of HPAS were correlated with clinical response. While no difference in treatment response between the ointments was seen, HPAS was more marked with agent B (84%) than A (22%) and persisted longer.
GCMS provided a sensitive index of HPAS and revealed evidence of adrenal adrogen as well as glucocorticoid suppression. We found that plasma cortisol though less sensitive than GOB does provide a rapid and practical estimate of cotaneous absorption of topical steroids and HPAS.
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Gotlin, R., Fennessey, P., Morelli, J. et al. COMPARISON OF HYPOTHALAMUS PITUITARY ADRENAL AXIS SUPPRESSION (HPAS) FROM TOPICAL STEROIDS BY STANDARD ENDOCRINE FUNCTION TESTING AND GAS CHROMATOGRAPHY MASS SPECTFOMETRY(GCMS). Pediatr Res 21 (Suppl 4), 247 (1987). https://doi.org/10.1203/00006450-198704010-00482
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DOI: https://doi.org/10.1203/00006450-198704010-00482