Adrenal function during topical oral corticosteroid treatment

Plasma cortisol (hydrocortisone) levels were measured in 42 subjects before and during administration of topical oral corticosteroids. Topical administration of 0.3-0.4 mg. of betamethasone disodium phosphate daily caused partial suppression of adrenal function in 8 out of 10 subjects tested. The adrenal function remained normal in 14 patients treated with 10 mg. of hydrocortisone hemisuccinate daily for periods of up to three years. Betamethasone 17-valerate also failed to cause adrenal suppression in doses of 0.4 mg. per day in 17 patients. The adrenal glands failed to respond normally to stimulation with Synacthen (tetracosactrin) in selected subjects with depressed plasma cortisol levels. Therapeutic doses of topical oral hydrocortisone hemisuccinate and betamethasone 17-valerate may be used in adults with oral lesions without fear of affecting adrenal function. Betamethasone disodium phosphate, however, should be avoided, as it may cause adrenal suppression.