Multidisciplinary diagnosis and treatment of iatrogenic Cushing syndrome in a patient with obsessive-compulsive disorder

Iatrogenic Cushing syndrome caused by topical corticosteroid preparations is only reported in infants. We describe a case in a patient with obsessive-compulsive disorder: the patient had tic disorder and obsessive-compulsive disorder, and the condition was under stable control. After the appearance of oral ulcers, the patient uncontrollably used a large amount of chlorhexidine dexamethasone membranes, resulting in iatrogenic Cushing syndrome. The fatty liver and abnormal liver function associated with Cushing syndrome led to the discontinuation of fluvoxamine and aripiprazole for obsessive-compulsive disorder. The patient’s tic and compulsive symptoms worsened, and he repeatedly bit his tongue. Under multidisciplinary diagnosis and treatment in emergency department, endocrinology department, psychological department, and dentistry department, both the mental and physical symptoms were controlled and the patient’s prognosis was satisfactory. Genetic testing revealed no clear abnormalities that could explain the patient’s phenotype. Therefore, medication use on obsessive-compulsive disorder patients with somatic diseases should be monitored. Multidisciplinary cooperation, especially consultation liaison psychiatry in general hospitals, is essential for the diagnosis and treatment of patients with both physical and mental symptoms in general hospitals.