Adrenocortical Suppression by Topical Application of Glucocorticosteroids in Infants with Seborrheic Dermatitis

Fifteen infants with seborrheic dermatitis were treated with topical glucocorticosteroids (flumethasone pivalate 0.02%). Early morning plasma cortisol levels were determined prior to treatment, during the 10-day treatment period, and 2 days after its termination. The mean plasma cortisol level prior to treatment was 8.8 ± 3.4 μg%; after 2 days of application there was a significant decrease of the mean to 2.5 ± 1.3 μg% that persisted throughout the treatment period. Two days after termination of treatment, the mean plasma cortisol level rose to 7.1 ± 3.7 μg% but in five infants was still less than 5 μg% and in two less than 2 μg%, the latter two having shown the greatest involvement of the skin. The possibility of pituitary/adrenocortical inhibition similar to that observed with the systemic administration of glucocorticosteroids and the potential associated risks should be considered when treating cases that would require extensive application of flumethasone pivalate in infants.