[Occurrence of severe striae in adolescents with congenital adrenal hyperplasia and 21-hydroxylation deficiency treated with dexamethasone].

Dexamethasone has been proposed as therapy of congenital adrenal hyperplasia in adolescents with menstrual abnormalities. Seven patients previously treated with hydrocortisone (mean dosage of 26 mg/m2/day) or prednisone (6 mg/m2/day), received dexamethasone doses between 0.3 and 0.73 mg/m2/day during at least 4 months. Regular menses and satisfactory adrenal suppression were obtained in most cases, but the occurrence of severe striae, sometimes with excessive weight gain, led to the cessation of this treatment. Analysis of data indicate that glucocorticoid activity of dexamethasone is 50-90 times more potent than that of hydrocortisone. Its use, after cessation of growth, should be carefully monitored, starting with much lower doses when necessary.