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13 November 2017 : Case report  Japan

Change of Oral to Topical Corticosteroid Therapy Exacerbated Glucose Tolerance in a Patient with Plaque Psoriasis

Unusual or unexpected effect of treatment, Unexpected drug reaction , Rare disease

Yui Hongo1ABCDEF, Kenji Ashida2ABCDEFG, Kenji Ohe3DEF*, Munechika Enjoji3DE, Miyuki Yamaguchi1BCDEF, Tsuyoshi Kurata2BCDEF, Akiko Emoto4BCDEF, Hiroko Yamanouchi1BCDEF, Satoko Takagi1BCDE, Hitoe Mori1BCDEF, Nozomi Kawata1BCDEF, Yoshio Hisata2CDEF, Yuta Sakanishi2BE, Kenichi Izumi1BCDEF, Takashi Sugioka2BCDEF, Keizo Anzai1ADEFG

DOI: 10.12659/AJCR.905470

Am J Case Rep 2017; 18:1198-1203

Abstract

BACKGROUND: Psoriasis is known as the most frequent disease treated by long-term topical steroids. It is also known that patients with thick, chronic plaques require the highest potency topical steroids. However, the treatment is limited to up to four weeks due to risk of systemic absorption.

CASE REPORT: An 80-year-old man was diagnosed with type 2 diabetes 16 years before, and was being administered insulin combined with alpha glucosidase inhibitor. He was diagnosed with plaque psoriasis and his oral steroid treatment was switched to topical steroid treatment due to lack of improvement and poorly controlled blood glucose level. The hypoglycemic events improved after the psoriatic lesions improved.

CONCLUSIONS: Control of blood glucose level is difficult at the very beginning of topical steroid treatment for psoriasis especially if a patient is receiving insulin treatment. Intense monitoring of blood glucose level during initiation of topical steroid treatment is necessary to prevent unfavorable complications.

Keywords: Administration, Topical, Diabetes Mellitus, Type 2, Psoriasis

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923