Survival of patients with cystic fibrosis

cardiorespiratory arrest (the cause for which was not established).During her resuscitation she was dragged across a floor and received severe full thickness lacerations to the purpuric and atrophic areas of skin on both arms and both legs.The skin loss on her right leg required grafting.She was discharged seven weeks after admission.Subsequently she had pain and discomfort in areas of scar tissue.She required beclomethasone 1-1 5 mg daily for her asthma.While she was stabilised on a dose of 1 mg beclomethasone daily a short tetracosactrin test showed borderline impairment of her adrenal function (basal plasma cortisol concentration 150 nmol/l, 30 minutes after tetracosactrin 0-25 mg intramuscularly 531 nmoL/l).Although senile purpura and corticosteroid purpura resemble each other closely,4 this patient's age, the location of bruising on her legs4 and the appearance of the bruising some months after taking higher doses of inhaled beclomethasone suggest that her purpura was induced by the steroid.Doctors should continue to be aware of the possibility of appreciable systemic side effects of this form of treatment.