What is a potential side effect of long-term use of topical corticosteroids?

Long-term use of topical corticosteroids can lead to Cushingoid syndrome, which is characterized by symptoms and signs typically associated with excess cortisol in the body. These may include weight gain, particularly in the face and trunk, thinning of the skin, easy bruising, and elevated blood pressure. The risk of developing Cushingoid syndrome with topical corticosteroids is primarily due to systemic absorption, especially when used over large areas of the skin, under occlusion, or for extended periods.

The other options relate to potential effects that are less directly associated with topical corticosteroids. Hypoglycemia, for example, is more commonly a concern with systemic corticosteroids, particularly in patients who may also be on other diabetic medications. Hypertension and metabolic syndrome can arise from several factors, including lifestyle and other medications, but they are not specifically tied to the typical use of topical corticosteroids in the same way that Cushingoid syndrome is. Thus, while long-term use can impact various aspects of health, Cushingoid syndrome remains a distinctive risk related to corticosteroid therapy.