Corticosteroid applied to the skin can be absorbed in sufficient amount to produce systemic effect such as hypothalmic-pituitary-adrenal axis suppression, manifestation of Cushing's syndrome, hyperglycaemia and glucosuria. Tests which may be helpful in evaluating hypothalmic-pituitary-adrenal axis suppression include urinary free cortisol test and ACTH stimulation test. If the hypothalmic-pituitary-adrenal axis suppression is found, the drug should be withdrawn, frequency of application reduced or a weaker steroid used. Supplemental systemic corticosteroids may be required if signs and symptoms of steroid withdrawal occur.
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