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Additionally, her chronic AIHA came under control after 1 week of MDMP treatment, hemoglobinuria resolved and the bilirubin level decreased after 3 d of MDMP; the only side effect was a mild cushingoid appearance that regressed after 2 months of the treatment, despite continuation of a relatively low dose of MP (48 mg/d).
Cushingoid appearance manifests as moon facies, truncal obesity, and "buffalo hump," and is very troubling to patients, but is uncommon at doses below the physiologic glucocorticoid replacement range.
She experienced extreme anxiety, paranoia, agitation, insomnia and behavioural changes, and some associated systemic effects including developing a cushingoid appearance, alopecia, systemic and ocular hypertension, nausea and hypercholesterolemia.
Dermatoiogical changes can occur with steroid therapy, including a redistribution of subcutaneous fat causing the cushingoid appearance of central obesity, hump back, and moon face.
Cushingoid appearance and delayed healing of the cervical ulcerated lesion in the present case were attributed to prolonged use of systemic MPZ.