Systemic toxicity to betamethasone ointment

Topically applied betamethasone for actinic keratosis may trigger systemic side effects. Systemic side effects of topical betamethasone may completely resolve after discontinuation of the causative agent. A 59-year-old male patient with scalp actinic keratosis developed fatigue and the need to sleep shortly after starting topical betamethasone/diclofenac ointment. Additionally, he experienced vertigo, nausea, sleep disturbance, change in character and recognition, tiredness, visual impairment, and elevated blood pressure. Since all symptoms resolved completely within 48 hours after discontinuation of the ointment, they were attributed to glucocorticoids.