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Yes, arimidex has been shown to cause acne and hirsuitism in girls. It is also sometimes prescribed to block natural estrogen production in women with breast cancer, resulting in terrible side -effects from mimicking an instant menopause.
To illustrate explain how a 17-alpha-hydroxylase inhibitor (such as ketoconazole) might help, here is a popular link to a freely viewable chart of the basic adrenal hormone conversions -- http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/basics/steroidogenesis.html
As can be seen, 17-alpha-hydroxylase controls the conversions of (1) pregnenolone to 17-oh-pregnenolone, (2) progesterone to 17-oh-progesterone, and (3) both 17-oh-pregenolone and 17-oh-progesterone into the sex hormones, starting with dhea.
At lower doses, ketoconazole's dominant action is inhibiting 17-alpha-hydroxylase, with the effects mostly limited to inhibiting (3) the conversion of 17-oh-p* into sex hormones. If (and only if) your daughter's cortef dose is much larger than her actual cortisol-replacement needs for the sake of androgen suppression, it may be feasible to use a small dose of ketoconazole to help block androgen production. Thus allowing a smaller dose of cortef with reduced virilization and bone-aging effects.
There is a danger, at high/higher dosages ketoconazole can also inhibit other adrenal conversions and so hinder your daughter's already reduced natural cortisol production. The dosage is an important factor.
Caveat: same caveat, these are ideas for discussion with your endocrinologist, not medical advice.
