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PILEGGI, F.O. Analysis of the level of salivary cortisol in children carryng of phimosis and treated with corticosteroid topical. 2008. 60 f. Thesis (Doctoral) – Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2008. Phimosis has always been the reason of much discussion. Currently, the use of topical steroid is a well established alternative that is indicated in great number of cases. Since good results has been showed in the literature an indiscriminate use of topical steroid has been observed with long and repeated cycles. The local absorption of low doses of topical steroid is still not well understood. Reports in the medical literature show that prolonged use of topical steroid can cause local and/or systemic adverse effects. (Kelly, Cains et al., 1991; Golubovic, Milanovic et al., 1996; Yanagisawa, Baba et al., 2000) Concerned with this, we analysed the absorption of clobetasol in the topical treatment of the phimotic ring. Thirty-one children were submitted to the dosage of salivary cortisol was done prior and after treatment at 9 o’clock AM, and in 10 of these children at 9 AM and 11 PM, in order to observe the circadian rhythm and also differentiate endogenous from exogenous cortisol. Salivary cortisol values varied from 60 to 3790 ng/dl no statistical test of Wilcoxon (p=0,82). Although the values of prior and after treatment were similar we cannot state that the treatment is completely harmless due 2 children that presented dosages showing the suppression of axle hypothalamichypophysisadrenal (H-H-A). In conclusion, the clinical treatment of phimosis with topical clobetasol, twice a day during 8 weeks is safe, however we suggest that dosage of cortisol should be done before and during the treatment when a prolonged treatment is proposed.

Análise do nível do cortisol salivar em crianças portadoras de fimose e tratadas com corticóide tópico