Plasma Cortisol Suppression by Steroid Creams

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Abstract
Studies of plasma cortisol levels during treatment with fluocinolone acetonide, flurandrenolone acetonide, and triamcinolone acetonide creams under occlusive plastic dressings revealed a definite suppression with total body occlusion in four patients with psoriasis. The suppression of plasma cortisol was temporary, and there was a prompt return to pretreatment levels when treatment was stopped. No significant plasma cortisol suppression was observed in one normal and two subjects with alopecia treated with steroid creams under total body occlusion. Although a similar, but less pronounced, suppression of urinary 17-ketosteroids and 17-hydroxycorticosteroids was observed in several subjects, these determinations were not as reliable as plasma cortisol for detection of suppression of the adrenal-pituitary axis in these subjects.