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CORTICOSTEROID, ANTI-INFLAMMATORY

Hydrocortisone Use: As a topical corticosteroid, the drug is used for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.

Hydrocortisone Aeroseb-HC, Alphaderm, Cetacort, Cortaid, Cort-Dome, Cortenema, Cortril, Dermacort, Dermolate, Hydrocortone, Hytone, Proctocort, Rectocort, Synacort Anusol HC, CaldeCort		Adult: Topical Apply a small amount to the affected area 1–4 times/d. PR Insert 1% cream, 10% foam, 10–25 mg suppository, or 100 mg enema nightly
Hydrocortisone acetate Carmol HC, Colifoam, Cortaid, Cortamed, Cort-Dome, Cortef Acetate, Corticaine, Cortifoam, Cortiment A Epifoam, Hydrocortone Acetate
Alclometasone diproprionate Alclovate		Adult: Topical 0.05% cream or ointment applied sparingly b.i.d. or t.i.d.; may use occlusive dressing for resistant dermatoses.
Amcinonide Cyclocort		Adult: Topical Apply thin film b.i.d. or t.i.d.
Betamethasone dipropionate Diprolene, Diprolene AF, Doprosone, Maxivate, Alphatrex, Teladar
Betamethasone valerate Betatrex, Luxiq, Valisone, Psorion, Beta-Val		Adult: Topical Apply sparingly b.i.d.
Clobetasol propionate Dermovate, Temovate		Adult: Topical Apply sparingly b.i..d. (max 50 g/wk), or b.i.d. 3d/wk or 1–2 times/wk for up to 6 mo.
Clocortolone pivalate Cloderm		Adult: Topical Apply thin layer 1–4 times/d.
Desonide DesOwen, Tridesilon		Adult: Topical Apply thin layer b.i.d. to q.i.d.
Desoximetasone Topicort, Topicort-LP		Adult: Topical Apply thin layer b.i.d.
Dexamethasone Sodium Phosphate Decaderm		Adult: Topical Apply thin layer t.i.d. or q.i.d.
Diflorasone diacetate Florone, Florone E, Maxiflor, Psorcon		Adult: Topical Apply thin layer of ointment 1–3 times/d or cream 2–4 times/d.
Fluocinolone acetonide Fluoderm, Fluolar, Fluonid, Flurosyn, Synalar, Synalar-HP, Synemol		Adult: Topical Apply thin layer b.i.d. to q.i.d.
Fluocinonide Lidemol, Lidex, Lidex-E, Lyderm, Topsyn		Adult: Topical Apply thin layer b.i.d. to q.i.d.
Fluandrenolide Cordran, Cordran SP, Drenison		Adult: Topical Apply thin layer b.i.d. or t.i.d.; apply tape 1–2 times/d at 12 h intervals. Child: Topical Apply thin layer 1–2 times/d; apply tape once/d.
Fluticasone Cutivate		Adult, Child >3 mo: Topical Apply a thin film of cream or ointment to affected area once or twice daily.
Halcinonide Halog		Adult: Topical Apply thin layer b.i.d. or t.i.d. Child: Topical Apply thin layer once/d
Mometasone furoate Elocon		Adult: Topical Apply a thin film of cream or ointment or a few drops of lotion to affected area once/d.
Triamcinolone Aristocort, Atolone, Kenacort, Kenalog, Kenalog-E		Adult: Topical Apply sparingly b.i.d. or t.i.d.

Contraindicated in:

• Topical steroids contraindicated in presence of varicella, vaccinia, on surfaces with compromised circulation, and in
• children <2 y.

Cautious use in:

• Children;
• diabetes mellitus;
• stromal herpes simplex;
• glaucoma, tuberculosis of eye;
• osteoporosis;
• untreated fungal,
• bacterial, or viral infections

Adverse Effects:

• Skin: Skin thinning and atrophy, acne, impaired wound healing; petechiae, ecchymosis, easy bruisings; suppression of skin test reaction; hypopigmentation or hyperpigmentation, hirsutism, acneiform eruptions, subcutaneous fat atrophy; allergic dermatitis, urticaria, angioneurotic edema, increased sweating.

Clinical Implications: Administer retention enema preferably after a bowel movement. The enema should be retained at least 1 h or all night if possible. If an occlusive dressing is to be used, apply medication sparingly, rub until it disappears, and then reapply, leaving a thin coat over lesion. Completely cover area with transparent plastic or other occlusive device or vehicle. Avoid covering a weeping or exudative lesion. Usually, occlusive dressings are not applied to face, scalp, scrotum, axilla, and groin. Inspect skin carefully between applications for ecchymotic, petechial, and purpuric signs, maceration, secondary infection, skin atrophy, striae or milaria; if present, stop medication and notify physician. Warn patient not to self-dose with OTC topical preparations of a corticosteroid more than 7 d. They should not be used for children <2 y. If symptoms do not abate, consult physician. Usually, topical preparations are applied after a shower or bath when skin is damp or wet. Cleansing and application of prescribed preparation should be done with extreme gentleness because of fragility, easy bruisability, and poor-healing skin. Hazard of systemic toxicity is higher in small children because of the greater ratio of skin surface area to body weight. Apply sparingly. Urge patient on long-term therapy with topical corticosterone to check expiration date.