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16.
Ann Endocrinol (Paris) ; 64(3): 202-4, 2003 Jun.
Article in English | MEDLINE | ID: mdl-12910062

ABSTRACT

We report a case of symptomatic topical corticosteroid-induced adrenal insufficiency and diabetes in a 46-yr old HIV 1 positive woman of African descent. Topical Betamethasone dipropionate 0.05%-containing creams were used for the purpose of bleaching over a 2 month period prior to the acute episode. She recovered from her acute onset diabetes with ketosis and adrenal insufficiency a few months after withdrawal of corticosteroids. Despite possible discussion about pathophysiology of diabetes because acute-onset remitting diabetes is not rare in patients of African descent, and diabetes may occur in patients taking anti-retroviral treatments, no other cause of a hypothalamo-pituitary-adrenal axis disorder was found. This case suggests that chronic use of high dose topical corticosteroid containing creams should be ruled out in patients presenting with Hypothalamo-Pituitary-Adrenal hypofunction.


Subject(s)
Adrenal Insufficiency/chemically induced , Anti-Inflammatory Agents/adverse effects , Betamethasone/analogs & derivatives , Betamethasone/adverse effects , Diabetes Mellitus/chemically induced , Acquired Immunodeficiency Syndrome/complications , Administration, Topical , Africa South of the Sahara/ethnology , Female , France , Glucocorticoids , Humans , Middle Aged
17.
Ann Dermatol Venereol ; 129(6-7): 866-9, 2002.
Article in French | MEDLINE | ID: mdl-12218913

ABSTRACT

PATIENTS AND METHODS: We studied prospectively the feasibility of post exposure prophylaxis against HIV in 93 subjects consulting after sexual exposure at STD Center of Hopital Saint-Louis. Among the 93 subjects, 76 were men (45 homosexual) and 17 women. RESULTS: Delay to consultation was 38 h. Among sexual exposure 90 p. 100 were anal or vaginal intercourse and 10 p. 100 oral intercourse. Fifty percent were unprotected. Seventy-five percent of source subject HIV status was unknown, but controlled negative in 14 p. 100 of cases. Three subjects were infected initially. Seventy-two subjects were treated, with triple regimen, for 30 days without severe adverse event. Twenty-five percent were lost to follow up before the end of treatment, only 54 controlled their serology after the end of treatment (after 1 month: 70 p. 100, after 2 months: 51 p. 100 and after 4-6 months: 13 p. 100). DISCUSSION: This study underlines the difficulty in obtaining clinical and serological control after post exposure prophylaxis, even in a STD Department involved in prevention and counseling.


Subject(s)
Anti-HIV Agents/therapeutic use , HIV Infections/prevention & control , HIV Infections/transmission , Indinavir/therapeutic use , Lamivudine/therapeutic use , Nelfinavir/therapeutic use , Sexual Behavior , Zidovudine/therapeutic use , AIDS Serodiagnosis , Drug Therapy, Combination , Feasibility Studies , Female , HIV Infections/blood , HIV Infections/diagnosis , HIV Infections/epidemiology , Humans , Male , Paris/epidemiology , Prospective Studies , Sexual Behavior/statistics & numerical data , Time Factors , Treatment Outcome
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