Iatrogenic Cushing Syndrome Secondary to Prolonged Topical Corticosteroid Therapy in an Infant with Atopic Dermatitis: A Case Report

Introduction Cushing syndrome refers to the clinical manifestations resulting from chronic exposure to excess glucocorticoids. Iatrogenic forms account for the majority of cases observed in clinical practice. We report a case of iatrogenic Cushing syndrome induced by prolonged topical corticosteroid therapy in an infant. Case Report An 11-month-old infant was referred for excessive weight gain that had gradually developed over the past two months. Clinical examination revealed marked truncal obesity associated with a moon facies. Dermatological examination showed eczematous lesions on the face consistent with atopic dermatitis. Medical history revealed daily application of a high-potency topical corticosteroid for approximately six months. No other corticosteroid exposure was reported. Given the history of prolonged topical corticosteroid use and the suggestive clinical findings, a diagnosis of iatrogenic Cushing syndrome secondary to systemic absorption of topical corticosteroids was established. Discussion Iatrogenic Cushing syndrome secondary to topical corticosteroids remains rare but is likely underdiagnosed. Infants represent a particularly vulnerable population due to their relatively large body surface area compared to body weight, thin skin, and immature skin barrier function. This case highlights the importance of parental education regarding the appropriate use of topical corticosteroids and the need for regular medical follow-up. Conclusion Iatrogenic Cushing syndrome secondary to topical corticosteroids should be considered in any infant presenting with excessive weight gain or cushingoid facies while receiving topical corticosteroid therapy. Prevention relies on appropriate prescribing, limited treatment duration, and careful clinical monitoring.