The Prevalence of Tertiary Adrenal Insufficiency in Patients Receiving Topical Glucocorticoid Treatment for Oral Lichen Planus

Abstract Objective: Glucocorticoid (GC) treatment suppress the hypothalamic-pituitary-adrenal axis, which may lead to tertiary adrenal insufficiency. This study aimed investigate prevalence of insufficiency among patients with oral lichen planus treated topical GC (clobetasol propionate) in cavity, a standard option for this condition. Methods: In cross-sectional study, we included 24 receiving long-term (> 6 weeks) clobetasol propionate treatment. Adrenal function was assessed by measuring serum cortisol between 8–9 AM, after withdrawal 48 hours. For concentrations below 280 nmol/L (10 µg/dL), 250 µg corticotropin stimulation test performed. Results: Twenty had normal (range 280–621 nmol/L), whereas four low (13, 45, 63, and 229 nmol/L, respectively). A revealed partial two (serum peak level 350 360 nmol/L) severe another 150 210 nmol/L). Conclusion: small approximately 20% chronic GCs It is essential be aware potential risk inform about need stress-doses during an intercurrent illness episode.