Topical corticosteroids

Question 1

Hydrocortisone 0.1%-2.5% potency

Answer 1

Mild

Question 2

Alclometasone dipropionate 0.05% (Modrasone) potency

Answer 2

Moderate

Question 3

Betamethasone valerate 0.025% (Betnovate-RD) potency

Answer 3

Moderate

Question 4

Clobetasone butyrate 0.05% (Eumovate) potency

Answer 4

Moderate

Question 5

Fluocinolone acetonide 0.00625% (Synalar 1 in 4 dilution) potency

Answer 5

Moderate

Question 6

Fludroxycortide 0.0125% (Haelan) potency

Answer 6

Moderate

Question 7

Beclometasone dipropionate 0.025% potency

Answer 7

Potent

Question 8

Betamethasone dipropionate 0.05% (Diprosone) potency

Answer 8

Potent

Question 9

Betamethasone valerate 0.1% (Betnovate) potency

Answer 9

Potent

Question 10

Diflucortolone valerate 0.1% (Nerisone) potency

Answer 10

Potent

Question 11

Fluocinolone acetonide 0.025% (Synalar) potency

Answer 11

Potent

Question 12

Fluocinonide 0.05% (Metosyn) potency

Answer 12

Potent

Question 13

Fluticasone propionate 0.05% (Cutivate) potency

Answer 13

Potent

Question 14

Hydrocortisone butyrate 0.1% (Locoid) potency

Answer 14

Potent

Question 15

Mometasone furoate 0.1% (Elocon) potency

Answer 15

Potent

Question 16

Clobetasol propionate 0.0525% (Dermovate, Clarelux) potency

Answer 16

Very potent

Question 17

Diflucortolone valerate 0.3% (Nerisone forte) potency

Answer 17

Very potent

Question 18

Characteristics of solutions

Answer 18

• low viscosity, alcohol or water based liquids
• easy to apply, non-greasy
• very drying if alcohol is the base, can sting sore skin

Question 19

Characteristics of lotions

Answer 19

• thicker than solutions
• for treating large or hairy areas, contain alcohol, drying effect on exudative lesions

Question 20

Characteristics of creams

Answer 20

• thicker than lotions, suitable for moist/weepy lesions
• less potent than ointments
• moisturising without being greasy
• preferred, esp for face and plams

Question 21

Characteristics of ointments

Answer 21

• preferred for dry, lichenified or scaly lesions
• occlusive effect increases penetration
• prolonged emollient effect
• less likely to cause irritation as usually PF

Question 22

Characteristics of gels and mousses

Answer 22

• gels are thicker than solutions, and can be drying
• mousses are stable, non-greasy foams
• can both be used for scalp conditions

Question 23

How long should topical corticosteroids be used for?

Answer 23

Short bursts of 3-7 days to achieve control, then withdrawn gradually

Question 24

Timing between use of steroids and emollients

Answer 24

Wait 20-30 minutes between application of topical corticosteroids are emollients

Question 25

What area would 1 FTU cover?

Answer 25

About 500mg, will cover area twice that of the flat of the hand with fingers together

Question 26

Contraindications of topical corticosteroids

Answer 26

- Bacterial, fungal or viral skin conditions - Rosacea - Perioral dermatitis - Acne vulgaris - Anogenital pruritis

Question 27

Systemic adverse effects of topical corticosteroids

Answer 27

- Adrenal suppresion - Cushing's syndrome - Growth suppression - Visual disturbance (refer to opthalmologist)