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Topical Corticosteroids
See Also
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Topical Dermatologic Praparations
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Preparation
Bases
Corticosteroid Potency Selection
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Low potency topical Corticosteroids
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Face
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Groin
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Intertriginous areas
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Mid-potency topical Corticosteroids
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Thin skin trunk areas
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Extremity lesions
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High potency topical Corticosteroids
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Thick skin trunk areas
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Extremity lesions
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Very high or super-potent Corticosteroids
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Very thick-skinned areas
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Palms and soles
Pearls
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Once daily dosing is as effective as bid-tid dosing
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Adjunctive measures: Occlusion
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Increases potency of steroid 10 fold
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Apply shower cap, plastic bag, or vinyl suit
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Use for stubborn areas
Adverse Effects of Topical Steroids
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Percutaneous absorption
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Skin atrophy
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Rebound papular dermatitis after medium-high potency
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Avoid high potency steroid on genital or face
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Striae formation
Level 1: Ultra-High Potency
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Halobetasol propionate (Ultravate)
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Preparations: 0.05% cream and ointment
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Clobetasol propionate (Temovate)
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Preparations: 0.05% cream and ointment
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Betamethasone dipropionate augmented (Diprolene)
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Preparations: 0.05% cream and ointment
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Diflorasone diacetate (Psorcon) 0.05% ointment
Level 2: Very High Potency
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Halcinonide (Halog) 0.1% cream
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Amcinonide (Cyclocort) 0.1% ointment
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Betamethasone dipropionate augmented (Diprolene AF)
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Preparation: 0.05% cream
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Betamethasone dipropionate (Diprosone)
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Preparation: 0.05% ointment
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Mometasone furoate (Elocon) 0.1% ointment
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Diflorasone diacetate (Florone) 0.05% ointment
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Fluocinonide (Lidex) 0.05% cream, gel, and ointment
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Diflorasone diacetate (Maxiflor) 0.05% ointment
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Desoximetasone (Topicort) 0.25% cream and ointment
Level 3: High Potency
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Halcinonide (Halog)
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Preparations: 0.1% ointment,
Emollient,
cream
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Triamcinolone acetonide (Aristocort A)
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Preparations: 0.1% ointment
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Amcinonide (Cyclocort) 0.1% cream and lotion
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Betamethasone dipropionate (Diprosone) 0.05% cream
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Diflorasone diacetate (Florone) 0.05% cream
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Fluocinonide (Lidex-E) 0.05% cream
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Diflorasone diacetate (Maxiflor) 0.05% cream
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Mometasone furoate (Elocon) 0.1% cream
Level 4: Medium-High Potency
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Hydrocortisone valerate (Westcort) 0.2% ointment
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Triamcinolone acetonide (Kenalog)
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Preparations: 0.1% cream and ointment
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Flurandrenolide (Cordran) 0.05% ointment
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Flucinolone acetonide (Synalar) 0.025% ointment
Level 5: Medium Potency
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Hydrocortisone valerate (Westcort) 0.2% cream
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Triamcinolone acetonide (Kenalog) 0.1% lotion
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Flurandrenolide (Cordran) 0.05% cream
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Betamethasone dipropionate (Diprosone) 0.05% lotion
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Hydrocortisone butyrate (Locoid) 0.1% cream
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Flucinolone acetonide (Synalar) 0.025% cream
Level 6: Low Potency
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Alclometasone dipropionate (Aclovate)
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Preparations: 0.05% ointment and cream
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Betamethasone valerate (Valisone) 0.05% lotion
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Fluocinolone acetonide (Synalar)
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Preparations: 0.01% solution and cream
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Desonide (Tridesilon) 0.05% cream
Level 7: Lowest Potency
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Hydrocortisone1%, 2.5%
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Dexamethasone
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Flumethasone
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Prednisolone
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Methyprednisolone
References
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Kaplan (2001) CMEA Medicine Lecture, San Diego
2003