Sydney doctors have warned about the increasing use of prescribed ‘magic mouthwashes’ after a 76-year-old woman developed iatrogenic Cushing’s syndrome while using such a rinse. 

She had been on the compounded oral rinse, which contained the potent topical corticosteroid clobetasol propionate, for 12 months after it was prescribed by her oral medicine specialist. 

But the patient reported fatigue, limb bruising, hair thinning, irritability and 3-4kg weight loss over the past year, according to the doctors from Royal Prince Alfred Hospital. 

She was urgently referred to the endocrine clinic for suppressed morning serum cortisol levels (<28nmol/L), where doctors found she had Cushing’s syndrome features such as facial swelling, skin thinning, proximal muscle weakness and bruising.