48

Topical Steroid Usage

(Corticosteroid)

(
1)

Psoriasis(intertriginous)
Atopic dermatitis (children)
Seborrheic dermatitis
Intertrigo (non-infectious)

Psoriasis
Atopic dermatitis (adults)
Nummular eczema
Allergic contact dermatitis,
subacute phase
Primary irritant dermatitis
Papular urticaria
Parapsoriasis
Lichen simplex chronicus

Palmoplantar psoriasis
Psoriasis of nails
Dyshidrotic eczema
Lupus erythematosus
Pemphigus
Lichen planus
Granuloma annulare
Necrobiosis lipoidica
diabeticorum
Sarcoidosis
Allergic contact dermatitis,
acute phase
Insect bites

49

1.
1.1 (Form):

(Base) (form)

1. (ointment):

2. (cream and lotion):

3. (lotion solution),
(gel), (spray) :

propylene glycol

50

1.2 (Potency)
2
Vasoconstriction assay
Generic name
Trade name
Dermovate cream
Clobetasol propionate 0.05%
Super-potent
Diprotop cream, ointment
Augmented betamethasone dipropionate
0.05%
Potent
Betamethasone dipropionate 0.05%
Diprosone ointment

Desoximetasone 0.25%
Topicort
Esperson
Diprosone Cream
Betamethasone dipropionate 0.05%
Moderately
Visderm cream, lotion
Amcinonide 0.1%
Potent

Arisocort A 0.1%
Triamcinolone acetonide 0.1%

TA cream 0.1%
Elomet cream
Mometasone furoate 0.1%
Betnovate cream
Betamethasone valerate 0.1%
Synalar cream
Fluocinolone acetonide 0.025%
Dermatop cream
Prednicarbae 0.1%
TA cream 0.02%
Triamcinolone acetonide 0.02%
Aristocort 0.02%
Eumovate
Clobetasone butyrate 0.5%
MILD
Hydrocortisone 1-2%
Hydrocortisone cream

Prednisolone 0.5%
Prednisil cream
-
-

*

51

2.
1.

2.

3.
1. (
)

2

2.

4. :

5.

6. :




(Tachyphylaxis)

-
3
-
3
7.
2

8.
- 1
100 (
30 )
-
50
-
100
9.
1.

2.

1. (local side effect)

1. Atrophic changes ,
(striae), (telangiectasia),
(purpura),
2. (hypopigmentation)
3. (hypertrichosis)
4. , rosacea, perioral dermatitis

52

5 . :


6.


2. (systemic side
effect)

2.1

2.2
(HPA-axis)
2.3 Iatrogenic Cushings syndrome
2.4
References
1. Baumann L, Kerdel F. Topical
glucocorticoids. In: Freedberg IM,
Eisen AZ, Wolff K, eds. Dermatology
in General Medicine. New York:
McGraw-Hill, 1999; 2713-7.

2. riffiths WAD, Wilkinson JD. Topical therapy. In:

Champion RH, Burton JL, Burns DA, Breathnach

SM, eds. Rook/Wilkinson/Ebling. Textbook of
Dermatology. Oxford: Blackwell Science, 1998;
3519-51.
3. Guin JD. Contact sensitivity to topical
corticosteroids. J Am Acad Dermatol 1984; 10:
773-82.
4. Hepburn D, Yohn JJ, Weston WL. Topical steroid
treatment in infants, children and adolescents.
Adv Dermatol 1994; 9: 225-54.
5. Lepoittevin JP, Drieghe J, Dooms-Goossens A.
Studies in patients with corticosteroid contact
allergy: understanding cross-reactivity among
different steroids. Arch Dermatol 1995; 131:31-7.
6. Singh G, Singh PK. Tachyphylaxis to topical
steroid measured by histamine-induced wheal
suppression. Int J Dermatol 1986; 25:324-6.
7. Stoughton RB. The vasoconstrictor assay in
bioequivalence testing: practical concerns and
recent developments. Int J Dermatol 1992; 31:26-8.
8. Yohn
JJ,
Weston
WL.
Topical
glucocorticosteroids. Curr Probl Dermatol 1990;
2:31-63.