II. Pearls

  1. Once daily dosing is as effective as 2-3 times daily dosing
    1. Green (2005) Br J Dermatol 152:130-41 [PubMed]
  2. Adjunctive measures: Occlusion
    1. Increases potency of steroid 10 fold
    2. Apply shower cap, plastic bag, or vinyl suit
    3. Use for stubborn areas
  3. Vehicle
    1. Ointments
      1. More potent than creams
      2. More greasy than creams
        1. Avoid on oozing lesions, or intertriginous folds
        2. Avoid in moist or hot environment
    2. Creams
      1. Preservatives may result in Contact Dermatitis
    3. Lotions
      1. Least potent, and least hydrating of vehicles
  4. Quantity to prescribe (10 day supply for twice daily dosing)
    1. See Topical Medication Quantity
    2. Face and neck: 30 grams for adult (15 g for child)
    3. Hand: 15 grams for adult (7.5 g for child)
    4. Arm: 30 grams for adult (15 g for child)
    5. Leg: 60 grams for adult (30 g for child)
    6. Body: 300 grams for adult (150 g for child)
  5. References
    1. Buys (2007) Am Fam Physician 75:523-8 [PubMed]

III. Adverse Effects of Topical Steroids

  1. Percutaneous absorption with systemic steroid effects
  2. Skin atrophy
  3. Rebound papular dermatitis after medium-high potency
    1. Avoid high potency steroid on genital or face
  4. Striae formation
  5. Petechiae
  6. Telangiectasia
  7. Acne Vulgaris

IV. Example: Low cost, generic steroids

  1. Level 1: Clobetasol Propionate 0.05% ointment
  2. Level 2: Betamethasone Dipropionate 0.05% ointment
  3. Level 3: Betamethasone Dipropionate 0.05% cream
  4. Level 4: Triamcinolone Acetonide 0.1% ointment
  5. Level 5: Triamcinolone Acetonide 0.1% ointment
  6. Level 6: Fluocinolone Acetonide 0.01% cream
  7. Level 7: Hydrocortisone 1% cream

V. Preparations: Level 1 (Ultra-High Potency)

  1. Halobetasol Propionate (Ultravate)
    1. Preparations: 0.05% cream and ointment
  2. Clobetasol Propionate (Temovate)
    1. Preparations: 0.05% cream and ointment
  3. Betamethasone Dipropionate augmented (Diprolene)
    1. Preparations: 0.05% cream and ointment
  4. Diflorasone diacetate (Psorcon) 0.05% ointment

VI. Preparations: Level 2 (Very High Potency)

  1. Halcinonide (Halog) 0.1% cream
  2. Amcinonide (Cyclocort) 0.1% ointment
  3. Betamethasone Dipropionate augmented (Diprolene AF)
    1. Preparation: 0.05% cream
  4. Betamethasone Dipropionate (Diprosone)
    1. Preparation: 0.05% ointment
  5. Mometasone furoate (Elocon) 0.1% ointment
  6. Diflorasone diacetate (Florone) 0.05% ointment
  7. Fluocinonide (Lidex) 0.05% cream, gel, and ointment
  8. Diflorasone diacetate (Maxiflor) 0.05% ointment
  9. Desoximetasone (Topicort) 0.25% cream and ointment

VII. Preparations: Level 3 (High Potency)

  1. Halcinonide (Halog)
    1. Preparations: 0.1% ointment, Emollient, cream
  2. Triamcinolone Acetonide (Aristocort A)
    1. Preparations: 0.1% ointment
  3. Amcinonide (Cyclocort) 0.1% cream and lotion
  4. Betamethasone Dipropionate (Diprosone) 0.05% cream
  5. Diflorasone diacetate (Florone) 0.05% cream
  6. Fluocinonide (Lidex-E) 0.05% cream
  7. Diflorasone diacetate (Maxiflor) 0.05% cream
  8. Mometasone furoate (Elocon) 0.1% cream

VIII. Preparations: Level 4 (Medium-High Potency)

  1. Hydrocortisone valerate (Westcort) 0.2% ointment
  2. Triamcinolone Acetonide (Kenalog)
    1. Preparations: 0.1% cream and ointment
  3. Flurandrenolide (Cordran) 0.05% ointment
  4. Flucinolone Acetonide (Synalar) 0.025% ointment

IX. Preparations: Level 5 (Medium Potency)

  1. Hydrocortisone valerate (Westcort) 0.2% cream
  2. Triamcinolone Acetonide (Kenalog) 0.1% lotion
  3. Flurandrenolide (Cordran) 0.05% cream
  4. Betamethasone Dipropionate (Diprosone) 0.05% lotion
  5. Betamethasone valerate (Valisone): 0.1% cream, lotion
  6. Hydrocortisone butyrate (Locoid) 0.1% cream
  7. Flucinolone Acetonide (Synalar) 0.025% cream

X. Preparations: Level 6 (Low Potency)

  1. Alclometasone dipropionate (Aclovate)
    1. Preparations: 0.05% ointment and cream
  2. Fluocinolone Acetonide (Synalar)
    1. Preparations: 0.01% solution and cream
  3. Desonide (Desowen)
    1. Preparations: 0.05% cream and ointment

XI. Preparations: Level 7 (Lowest Potency)

  1. Hydrocortisone
    1. Preparations: 1%, 2.5% lotion, cream, ointment,

XII. Indications

  1. High potency Corticosteroids (Level 1-3)
    1. Alopecia Areata
    2. Atopic Dermatitis (refractory cases)
    3. Discoid Lupus
    4. Eczematous Dermatitis of hands (severe cases)
    5. Hyperkeratotic Eczema
    6. Lichen Planus
    7. Lichen Sclerosus (skin)
    8. Lichen Simplex Chronicus
    9. Nummular Eczema
    10. Poison Ivy (severe cases)
    11. Psoriasis
  2. Medium potency Corticosteroids (Level 4-5)
    1. Asteatotic Eczema
    2. Atopic Dermatitis
    3. Lichen Sclerosus (vulvar)
    4. Nummular Eczema
    5. Perianal inflammation (severe cases)
    6. Scabies (only after the anti-Scabies agent has been used)
    7. Seborrheic Dermatitis
    8. Severe Intertrigo
    9. Stasis Dermatitis
  3. Low potency Corticosteroids (Level 6-7)
    1. Dermatitis (face, Eyelids, diaper area)
    2. Intertrigo
    3. Perianal inflammation
  4. References
    1. Ference (2009) Am Fam Physician 79(2): 135-40 [PubMed]

XIII. Dosing: Corticosteroid Potency Selection by distribution

  1. Low potency Topical Corticosteroids
    1. Face
    2. Groin
    3. Intertriginous areas
  2. Mid-potency Topical Corticosteroids
    1. Thin skin trunk areas
    2. Extremity lesions
  3. High potency Topical Corticosteroids
    1. Thick skin trunk areas
    2. Extremity lesions
  4. Very high or super-potent Corticosteroids
    1. Very thick-skinned areas
    2. Palms and soles

XIV. References

  1. Kaplan (2001) CMEA Medicine Lecture, San Diego

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Cost: Medications

ultravate (on 1/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
ULTRAVATE X OINTMENT COMBO PAC $3.21 per gram
mometasone furoate (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
MOMETASONE FUROATE 0.1% CREAM Generic $0.25 per gram
MOMETASONE FUROATE 0.1% OINT Generic $0.22 per gram
MOMETASONE FUROATE 0.1% SOLN Generic $0.21 per ml
MOMETASONE FUROATE 50 MCG SPRY Generic $6.82 per gram
fluocinonide (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
FLUOCINONIDE 0.05% CREAM Generic $1.20 per gram
FLUOCINONIDE 0.05% GEL Generic $2.19 per gram
FLUOCINONIDE 0.05% OINTMENT Generic $1.65 per gram
FLUOCINONIDE 0.05% SOLUTION Generic $1.13 per ml
FLUOCINONIDE 0.1% CREAM Generic $4.84 per gram
FLUOCINONIDE-E 0.05% CREAM Generic $1.65 per gram
desoximetasone (on 4/19/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
DESOXIMETASONE 0.05% CREAM Generic $4.59 per gram
DESOXIMETASONE 0.05% GEL Generic $3.78 per gram
DESOXIMETASONE 0.05% OINTMENT Generic $4.35 per gram
DESOXIMETASONE 0.25% CREAM Generic $1.59 per gram
DESOXIMETASONE 0.25% OINTMENT Generic $3.87 per gram
topicort (on 3/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
TOPICORT 0.25% SPRAY $5.02 per ml
halog (on 1/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
HALOG 0.1% CREAM $14.46 per gram
HALOG 0.1% OINTMENT $12.33 per gram
kenalog (on 2/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
KENALOG 0.147 MG/GRAM SPRAY Generic $2.77 per gram
KENALOG-10 10 MG/ML VIAL $2.25 per ml
KENALOG-40 40 MG/ML VIAL $8.77 per ml
desonide (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
DESONIDE 0.05% CREAM Generic $2.60 per gram
DESONIDE 0.05% LOTION Generic $2.53 per ml
DESONIDE 0.05% OINTMENT Generic $2.98 per gram

Ontology: Beclomethasone Dipropionate (C0004906)

Definition (NCI) The dipropionate ester of a synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. After cell surface receptor attachment and cell entry, beclomethasone enters the nucleus where it binds to and activates specific nuclear receptors, resulting in an altered gene expression and inhibition of proinflammatory cytokine production.
Definition (PDQ) The dipropionate salt of a synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. After cell surface receptor attachment and cell entry, beclomethasone enters the nucleus where it binds to and activates specific nuclear receptors, resulting in an altered gene expression and inhibition of proinflammatory cytokine production. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39272&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39272&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C299" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH D001507
SnomedCT 116575004, 331007007, 38516009, 320477002, 331779003, 320620006
LNC LP35865-2, MTHU017342
English Dipropionate, Beclomethasone, Beclomethasone diprop [nose], Beclomethasone diprop [resp], Beclomethasone diprop [skin], (11beta,16beta)-9-Chloro-11-hydroxy-16-methyl-17,21-bis(1-oxopropoxy)pregna-1,4-diene-3,20-dione, Beclomethasone Dipropionate, Beclomethasone diprop [resp 2], Beclomethasone dipropionate [respiratory use 2], Beclomethasone dipropionate [nose], Beclomethasone dipropionate [respiratory use], (11beta,16beta)-9-Chloro-11-hydroxy-16-methyl-17,21-bis(1-oxopropoxy)pregna-1,4-diene-3,20-dione Dipropionate, beclomethasone dipropionate (medication), topical steroids beclomethasone dipropionate, Beclometasone dipropionate, beclomethasone dipropionate, BECLOMETHASONE DIPROPIONATE, Beclomethasone Dipropionate [Chemical/Ingredient], Beclomethasone dipropionate preparation, Beclometasone dipropionate [nose], Beclometasone dipropionate [respiratory use], Beclomethasone dipropionate [respiratory use] (product), Beclomethasone dipropionate [nose] (product), Beclometasone diprop [skin], Beclometasone dipropionate [respiratory use 2], Beclomethasone dipropionate [respiratory use 2] (product), Beclomethasone diprop [skin] (product), Beclomethasone dipropionate preparation (product), Beclometasone dipropionate preparation, Beclomethasone dipropionate, Beclomethasone dipropionate (substance), BDP, Beclomethasone diprop [skin] (substance), Beclomethasone dipropionate [nose] (substance), Beclomethasone dipropionate [respiratory use 2] (substance), Beclomethasone dipropionate [respiratory use] (substance), Beclomethasone dipropionate preparation (substance)
Spanish preparado de dipropionato de beclometasona, Dipropionato Beclometasona, dipropionato de beclometasona [uso respiratorio 2], dipropionato de beclometasona [uso respiratorio], dipropionato de beclometasona (uso nasal) (producto), dipropionato de beclometasona (uso dermatológico), dipropionato de beclometasona [uso respiratorio] (producto), dipropionato de beclometasona [uso respiratorio 2] (producto), dipropionato de beclometasona (uso nasal), preparado con dipropionato de beclometasona (producto), preparado con dipropionato de beclometasona, dipropionato de beclometasona (uso dermatológico) (producto), dipropionato de beclometasona (nasal) (producto), dipropionato de beclometasona (nasal), dipropionato de beclometasona (piel) (producto), dipropionato de beclometasona (piel), dipropionato de beclometasona (sustancia), dipropionato de beclometasona, preparado de dipropionato de beclometasona (producto), preparado de dipropionato de beclometasona (sustancia)
Portuguese Dipropionato de Beclometasona
German Beclomethasondiproprionat

Ontology: Fluocinolone Acetonide (C0016298)

Definition (NCI) The acetonide salt form of fluocinolone, a synthetic fluorinated corticosteroid with antiinflammatory, antipruritic and vasoconstrictive properties. Fluocinolone is a glucocorticoid receptor agonist that binds to cytoplasmic glucocorticoid receptors and subsequently translocates to the nucleus where it initiates the transcription of glucocorticoid-responsive genes such as lipocortins. Lipocortins inhibit phospholipase A2, thereby blocking the release of arachidonic acid from membrane phospholipids and preventing the synthesis of prostaglandins and leukotrienes, both are potent mediators of inflammation. Fluocinolone exerts its vasoconstrictive effect through inhibition of nitric oxide synthase, thereby blocking nitric oxide production and effectively diminishing the effect of nitric oxide on vascular smooth muscles leading to reduced blood flow.
Definition (MSH) A glucocorticoid derivative used topically in the treatment of various skin disorders. It is usually employed as a cream, gel, lotion, or ointment. It has also been used topically in the treatment of inflammatory eye, ear, and nose disorders. (From Martindale, The Extra Pharmacopoeia, 30th ed, p732)
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH D005446
SnomedCT 54147006, 331918005, 396059004
English Acetonide, Fluocinolone, Acetonide, Fluortriamcinolone, Fluortriamcinolone Acetonide, Pregna-1,4-diene-3,20-dione, 6,9-difluoro-11,21-dihydroxy-16,17-((1-methylethylidene)bis(oxy))-, (6alpha,11beta,16alpha)-, (6alpha,11beta,16alpha)-6,9-Difluoro-11,21-dihydroxy-16,17-[(1-methylethylidene)bis(oxy)]pregna-1,4-diene-3,20-dione, fluocinolone acetonide, Fluocinolone Acetonide, topical steroids fluocinolone acetonide, fluocinolone acetonide (medication), Fluocinolone Acetonide [Chemical/Ingredient], FLUOCINOLONE ACETONIDE, Fluocinolone acetonide (product), Fluocinolone acetonide, Fluocinolone acetonide (substance), Fluocinolone acetonide [dup] (substance)
Swedish Fluokinolonacetonid
Czech fluocinolonacetonid
Finnish Fluosinoloniasetonidi
Russian SINAFLAN, FLUORTRIAMTSINOLONA ATSETONID, FLIUOTSINOLONA ATSETONID, FTORTRIAMTSINOLONA ATSETONID, СИНАФЛАН, ФЛУОРТРИАМЦИНОЛОНА АЦЕТОНИД, ФЛЮОЦИНОЛОНА АЦЕТОНИД, ФТОРТРИАМЦИНОЛОНА АЦЕТОНИД
Italian Fluortriamcinolone acetonide, Fluocinolone acetonide
Croatian FLUOCINOLON-ACETONID
Polish Flucinar
Japanese エスアランF, フルオシノロンアセトニド, コリフェート, フルオルトリアムシノロンアセトニド, フルコートL, フルコート, フルゾン, フルベアン, フルポロン, ポリシラール
Spanish acetonida de fluocinolona (producto), acetonida de fluocinolona (sustancia), acetonida de fluocinolona, acetonuro de fluocinolona (producto), acetonuro de fluocinolona (sustancia), acetonuro de fluocinolona, Acetonida de Fluortriamcinolona, Fluocinolona Acetonida
Portuguese Fluocinolona-Acetonida, Acetonida de Fluocinolona, Fluocinolona Acetonida, Fluortriamcinolona Acetonida
French Fluocinolone acétonide
German Fluocinolonacetonid, Fluortriamcinolon-Acetonid

Ontology: Hydrocortisone topical preparation (C0020269)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
SnomedCT 91413005
English topical steroids hydrocortisone, hydrocortisone (topical), hydrocortisone (topical) (medication), topical hydrocortisone, hydrocortisone topical, Topical hydrocortisone, Hydrocortisone topical preparation (product), Hydrocortisone topical preparation, Hydrocortisone topical preparation, NOS, Hydrocortisone topical preparation (substance)
Spanish preparado tópico con hidrocortisona (producto), preparado tópico con hidrocortisona, preparado tópico de hidrocortisona (producto), preparado tópico de hidrocortisona (sustancia), preparado tópico de hidrocortisona

Ontology: Triamcinolone Acetonide (C0040866)

Definition (NCI) The acetonide salt form of triamcinolone, a synthetic glucocorticosteroid with immunosuppressive and anti-inflammatory activity. Triamcinolone acetonide binds to specific cytosolic glucocorticoid receptors and subsequently interacts with glucocorticoid receptor response element on DNA and alters gene expression. This results in an induction of the synthesis of certain anti-inflammatory proteins while inhibiting the synthesis of certain inflammatory mediators. Consequently, an overall reduction in chronic inflammation and autoimmune reactions are accomplished.
Definition (MSH) An esterified form of TRIAMCINOLONE. It is an anti-inflammatory glucocorticoid used topically in the treatment of various skin disorders. Intralesional, intramuscular, and intra-articular injections are also administered under certain conditions.
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH D014222
SnomedCT 126157006, 7155009, 329998000, 332006001, 331073005, 395913005
LNC LP35874-4, MTHU018765
English Acetonide, Triamcinolone, Triamcinolone Acetonide, Pregna-1,4-diene-3,20-dione, 9-fluoro-11,21-dihydroxy-16,17-((1-methylethylidene)bis(oxy))-, (11beta,16alpha)-, Triamcinolone aceton [mskel], Triamcinolone acetonide [skin], 9-alpha-Fluoro-11-beta,21-dihydroxy-16-alpha-isopropylidenedioxy-1,4-pregnadiene,3,20-dione, triamcinolone acetonide, Triamcinolone acetate [nose], Triamcinolone acetonide [musculoskeletal use], triamcinolone acetonide (medication), topical steroids triamcinolone acetonide, TRIAMCINOLONE ACETONIDE, Triamcinolone Acetonide [Chemical/Ingredient], acetonide triamcinolone, Triamcinolone acetonide preparation (product), Triamcinolone acetonide (product), Triamcinolone acetonide preparation, Triamcinolone acetate [nose] (product), Triamcinolone acetonide [skin] (product), Triamcinolone acetonide [musculoskeletal use] (product), Triamcinolone acetonide, Triamcinolone acetonide (substance), Triamcinolone acetate [nose] (substance), Triamcinolone acetonide [musculoskeletal use] (substance), Triamcinolone acetonide [skin] (substance), Triamcinolone acetonide preparation (substance)
Swedish Triamcinolonacetonid
Czech triamcinolonacetonid
Finnish Triamsinoloniasetonidi
Russian TRIAMTSINOLONA ATSETONID, KENALOG, КЕНАЛОГ, ТРИАМЦИНОЛОНА АЦЕТОНИД
Japanese トリアムシノロンアセトニド
Polish Acetonid triamcynolonu
Spanish acetonida de triamcinolona (uso dermatológico) (producto), acetonida de triamcinolona [uso musculoesquelético] (producto), acetonida de triamcinolona (producto), acetato de triamcinolona (uso nasal), preparado de acetonida de triamcinolona, acetato de triamcinolona (uso nasal) (producto), acetonida de triamcinolona (uso dermatológico), preparado de acetonida de triamcinolona (producto), acetonida de triamcinolona [uso musculoesquelético], acetato de triamcinolona (nasal) (producto), acetato de triamcinolona (nasal), acetonida de triamcinolona (piel) (producto), acetonida de triamcinolona (piel), acetonida de triamcinolona (sustancia), acetonida de triamcinolona, acetonuro de triamcinolona (producto), acetonuro de triamcinolona (sustancia), acetonuro de triamcinolona, preparado de acetonida de triamcinolona (sustancia), Triamcinolona Acetonida
French Triamcinolone acétonide
German Triamcinolonacetonid
Italian Triamcinolone acetonide
Portuguese Triancinolona Acetonida

Ontology: Clobetasol Propionate (C0055895)

Definition (NCI) The propionate salt form of clobetasol, a topical synthetic corticosteroid with anti-inflammatory, anti-pruritic, and vasoconstrictive properties. Clobetasol propionate exerts its effect by binding to cytoplasmic glucocorticoid receptors and subsequently activates glucocorticoid receptor mediated gene expression. This results in synthesis of certain anti-inflammatory proteins, while inhibiting the synthesis of certain inflammatory mediators. Specifically, clobetasol propionate appears to induce phospholipase A2 inhibitory proteins, thereby controlling the release of the inflammatory precursor arachidonic acid from membrane phospholipids by phospholipase A2.
Definition (MSH) This is the form in trademark preparations.
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH D002990
SnomedCT 331854005, 32197004
English Clobetasol Propionate, Clobetasol 17-Propionate, clobetasol propionate, CLOBETASOL PROPIONATE, clobetasol propionate (medication), topical steroids clobetasol propionate, Clobetasol Propionate [Chemical/Ingredient], clobetasol 17-propionate, Clobetasol propionate, Clobetasol propionate (substance), Clobetasol propionate [dup] (substance), Clobetasol 17 Propionate
Spanish propionato de clobetasol (sustancia), propionato de clobetasol

Ontology: diflorasone diacetate (C0057992)

Definition (NCI) The acetate salt form of diflorasone, a synthetic glucocorticoid with anti-inflammatory and immunosuppressive properties. Like other glucocorticoids, diflorasone enters the cell by diffusion across the cell membrane and binds to the glucocorticoid receptor (GR) in the cytoplasm. The receptor complex subsequently translocates to the nucleus and activates or represses genes by interacting with short, palindromic DNA sequences called glucocorticoid response element (GRE). Gene activation leads to the exertion of anti-inflammatory effects, e.g. upregulation of IkappaB, while gene repression inhibits production of pro-inflammatory cytokines such as interleukin-1 (IL-1), IL-2 and IL-6, thereby preventing activation of cytotoxic T-lymphocytes.
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH C014477
SnomedCT 38446009
English 6alpha,9-Difluoro-11beta,17,21-trihydroxy-16beta-methylpregna-1,4-diene-3,20-dione 17,21-Diacetate, 6alpha-Fluorobetamethasone-17,21 Diacetate, Diflorasone Diacetate, topical steroids diflorasone diacetate, diflorasone diacetate (medication), diflorasone diacetate, diflorasone diacetate [Chemical/Ingredient], DIFLORASONE DIACETATE, Diflorasone diacetate, Diflorasone diacetate (substance)
Spanish diacetato de diflorasona (sustancia), diacetato de diflorasona

Ontology: hydrocortisone valerate (C0063079)

Definition (NCI) The valerate salt form of hydrocortisone, a synthetic glucocorticoid receptor agonist with antiinflammatory, antipruritic and vasoconstrictive effects. Binding and activation of the glucocorticoid receptor results in the activation of lipocortin that in turn inhibits cytosolic phospholipase A2. Lack of phospholipase A2 prevents the release of arachidonic acid, precursor for inflammatory mediator prostaglandins and leukotrienes, from the cell membrane. Secondly, mitogen-activated protein kinase (MAPK) phosphatase 1 is induced, thereby leads to dephosphorylation and inactivation of Jun N-terminal kinase directly inhibiting c-Jun mediated transcription. Finally, transcriptional activity of nuclear factor (NF)-kappa-B is blocked, thereby inhibits the transcription of cyclooxygenase 2, which is essential for prostaglandin production.
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH C038363
SnomedCT 51612003
English hydrocortisone valerate, 11beta,17,21-Trihydroxypregn-4-ene-3,20-dione 17-Valerate, Hydrocortisone Valerate, topical steroids hydrocortisone valerate, hydrocortisone valerate (medication), HYDROCORTISONE VALERATE, hydrocortisone valerate [Chemical/Ingredient], Hydrocortisone valerate (substance), Hydrocortisone valerate, Hydrocortisone valerate, NOS
Spanish valerato de hidrocortisona (sustancia), valerato de hidrocortisona

Ontology: mometasone furoate (C0066700)

Definition (NCI) The furoate salt form of mometasone, a synthetic topical glucocorticosteroid receptor agonist with anti-inflammatory, anti-pruritic and vasoconstrictive properties. Mometasone furoate exerts its effect by binding to cytoplasmic glucocorticoid receptors and subsequently activates glucocorticoid receptor mediated gene expression. This results in synthesis of certain anti-inflammatory proteins, while inhibiting the synthesis of certain inflammatory mediators.. Specifically, mometasone furoate appears to induce phospholipase A2 inhibitory proteins, thereby controlling the release of the inflammatory precursor arachidonic acid from phospholipid membrane by phospholipase A2.
Definition (NCI_NCI-GLOSS) A drug that is used in a cream to treat certain skin conditions and in a nasal spray to treat sinus problems caused by allergies. It is being studied as a way to treat inflammation of the skin caused by radiation therapy. Elocon is a type of corticosteroid.
Definition (PDQ) The furoate salt form of mometasone, a synthetic topical glucocorticosteroid receptor agonist with anti-inflammatory, anti-pruritic and vasoconstrictive properties. Mometasone furoate exerts its effect by binding to cytoplasmic glucocorticoid receptors and subsequently activates glucocorticoid receptor mediated gene expression. This results in synthesis of certain anti-inflammatory proteins, while inhibiting the synthesis of certain inflammatory mediators.. Specifically, mometasone furoate appears to induce phospholipase A2 inhibitory proteins, thereby controlling the release of the inflammatory precursor arachidonic acid from phospholipid membrane by phospholipase A2. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=531049&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=531049&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C29268" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH C053915
SnomedCT 43059007, 332042009, 395802006
English mometasone furoate, (11beta,16alpha)-9,21-Dichloro-17-[(2-furanylcarbonyl)oxy]-11-hydroxy-16-methylpregna-1,4-diene-3,20-dione, Mometasone Furoate, topical steroids mometasone furoate, mometasone furoate (medication), MOMETASONE FUROATE, mometasone furoate [Chemical/Ingredient], furoate mometasone, Mometasone furoate (product), Mometasone furoate, Mometasone furoate (substance), Mometasone furoate [dup] (substance)
Spanish furoato de mometasona (producto), furoato de mometasona (sustancia), furoato de mometasona

Ontology: halobetasol propionate (C0098735)

Definition (NCI) The propionate salt form of halobetasol, a synthetic corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictor activities. Halobetasol, a topical steroid, diffuses across cell membranes to interact with cytoplasmic corticosteroid receptors located in both the dermal and intradermal cells, thereby activating gene expression of anti-inflammatory proteins mediated via corticosteroid receptor response element. Specifically, this agent induces phospholipase A2 inhibitory proteins, which inhibit the release of arachidonic acid, thereby inhibiting the biosynthesis of potent mediators of inflammation, such as prostaglandins and leukotrienes. As a result, halobetasol reduces edema, erythema, and pruritus through its cutaneous effects on vascular dilation and permeability.
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH C064466
SnomedCT 126085005, 126149008
English 6-fluoroclobetasol 17-propionate, 21-Chloro-6alpha,9-difluoro-11beta,17-dihydroxy-16beta-methylpregna-1,4-diene-3,20-dione 17-propionate, Halobetasol Propionate, halobetasol propionate (medication), topical steroids halobetasol propionate, HALOBETASOL PROPIONATE, Halobetasol propionate, Halobetasol propionate (substance), Halobetasol propionate preparation (product), Halobetasol propionate preparation, Halobetasol propionate preparation (substance), 6 alpha-fluoroclobetasol 17-propionate, halobetasol propionate
Spanish propionato de halobetasol (producto), preparado con propionato de halobetasol (producto), preparado con propionato de halobetasol, preparado de propionato de halobetasol (producto), preparado de propionato de halobetasol (sustancia), preparado de propionato de halobetasol, propionato de halobetasol (sustancia), propionato de halobetasol

Ontology: Topical form corticosteroids (C0304604)

Definition (NCI) Any synthetic steroid derivative exhibiting the same function as the naturally occurring corticosteroid hormone, formulated for topical application. Topical corticosteroids are applied to the skin where it exerts its effect, however, corticosteroids can be absorbed systemically after being applied locally. Topical corticosteroids are mainly used for the localized treatment of inflammation of the skin and help relieve symptoms such as itching, swelling and redness.
Concepts Pharmacologic Substance (T121)
SnomedCT 31057002, 331645009
English Topical corticosteroids, Topical corticosteroid preparation, Topical Corticosteroids, Topical Corticosteroid, corticosteroids topical, topical corticosteroids, corticosteroid topical, topical corticosteroid, Topical corticosteroid preparation (product), Topical form corticosteroid preparation, Topical form corticosteroids (product), Topical form corticosteroids, Topical corticosteroid, NOS, Topical corticosteroid preparation (substance), Topical corticosteroids (product), Topical corticosteroids (substance)
Spanish corticoesteroide de uso tópico (producto), corticosteroide, forma farmacéutica tópica (producto), corticoesteroide de uso tópico, corticoide, forma farmacéutica tópica, corticosteroide, forma farmacéutica tópica, preparado con corticosteroide, tópico, preparado con corticosteroide, tópico (producto), corticoesteroide tópico, corticosteroide tópico (producto), corticosteroide tópico (sustancia), corticosteroide tópico, corticosteroides tópicos (producto), corticosteroides tópicos

Ontology: Hydrocortisone creams (C0352305)

Concepts Clinical Drug (T200)
SnomedCT 331646005
English hydrocortisone creams, hydrocortisone cream, Hydrocortisone creams, Hydrocortisone creams (product), Hydrocortisone creams (substance)
Spanish crema con hidrocortisona, hidrocortisona, crema (producto), hidrocortisona, crema

Ontology: Hydrocortisone butyrate (C0352536)

Definition (NCI) The butyrate salt form of hydrocortisone, a synthetic glucocorticoid receptor agonist with antiinflammatory, antipruritic and vasoconstrictive effects. Binding and activation of the glucocorticoid receptor results in the activation of lipocortin that in turn inhibits cytosolic phospholipase A2. Lack of phospholipase A2 prevents the release of arachidonic acid, precursor for inflammatory mediator prostaglandins and leukotrienes, from the cell membrane. Secondly, mitogen-activated protein kinase (MAPK) phosphatase 1 is induced, thereby leading to dephosphorylation and inactivation of Jun N-terminal kinase directly inhibiting c-Jun mediated transcription. Finally, transcriptional activity of nuclear factor (NF)-kappa-B is blocked, thereby inhibits the transcription of cyclooxygenase 2, which is essential for prostaglandin production.
Concepts Pharmacologic Substance (T121) , Steroid (T110)
SnomedCT 331982002, 50665003
English 11-beta,17-alpha,21-Trihydroxy-4-pregnene-3,20-dione 17-alpha-butyrate, Hydrocortisone Butyrate, topical steroids hydrocortisone butyrate, hydrocortisone butyrate (medication), HYDROCORTISONE BUTYRATE, hydrocortisone butyrate, Hydrocortisone butyrate, Hydrocortisone butyrate (substance), Hydrocortisone butyrate, NOS, Hydrocortisone butyrate [dup] (substance)
Spanish butirato de hidrocortisona (sustancia), butirato de hidrocortisona

Ontology: Elocon (C0720180)

Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH C053915
English Elocon, elocon

Ontology: Maxiflor (C0721607)

Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH C014477
English Maxiflor, Allergan brand of diflorasone diacetate

Ontology: Psorcon (C0722905)

Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH C014477
English Psorcon, psorcon, Dermik brand 2 of diflorasone diacetate

Ontology: Betamethasone valerate (C0750848)

Definition (NCI) The 17-valerate ester of betamethasone, a synthetic glucocorticoid with metabolic, immunosuppressive and anti-inflammatory actions. Betamethasone valerate binds to specific intracellular glucocorticoid receptors and subsequently binds to DNA to modify gene expression. The synthesis of certain anti-inflammatory proteins is induced while the synthesis of certain inflammatory mediators is inhibited. As a result, there is an overall reduction in chronic inflammation and autoimmune reactions.
Definition (MSH) The 17-valerate derivative of BETAMETHASONE. It has substantial topical anti-inflammatory activity and relatively low systemic anti-inflammatory activity.
Concepts Pharmacologic Substance (T121) , Steroid (T110)
MSH D001624
SnomedCT 396005002, 66854004
English 17-Valerate, Betamethasone, Betamethasone 17 Valerate, Flubenisolonvalerate, Pregna-1,4-diene-3,20-dione, 9-fluoro-11,21-dihydroxy-16-methyl-17-((1-oxopentyl)oxy)-, (11beta,16beta)-, betamethasone valerate, BETAMETHASONE VALERATE 17, betamethasone valerate (medication), topical steroids betamethasone valerate, BETAMETHASONE VALERATE, Betamethasone Valerate, Betamethasone 17-Valerate, Valerate, Betamethasone, Betamethasone Valerate [Chemical/Ingredient], Betamethasone valerate, Betamethasone valerate product, Betamethasone valerate (product), Betamethasone valerate (substance)
Swedish Betametason 17-valerat
Czech betamethason 17-valerát
Finnish Beetametasoni-17-valeraatti
Italian Flubenisolone valerato, Betametasone 17-valerato, Betametasone valerato
Russian FLUBENIZOLONVALERAT, BETAMETAZONA-17-VALERAT, 17-ВАЛЕРАТ БЕТАМЕТАЗОНА, БЕТАМЕТАЗОНА ВАЛЕРАТ, БЕТАМЕТАЗОНА-17-ВАЛЕРАТ, BETAMETAZONA VALERAT, 17-VALERAT BETAMETAZONA, ФЛУБЕНИЗОЛОНВАЛЕРАТ
Japanese フルベニソロンバレレート, 吉草酸ベタメタゾン, 17-吉草酸ベタメタゾン
German BETAMETHASON VALERAT 17, Betamethason-17-Valerat, Flubenisolonvalerat
Polish 17-walerianian betametazonu
French Bétaméthasone valérate-17, Bétaméthasone valérate, Valérate de bétaméthasone
Spanish 17-Valerato de Betametasona, Not Translated[Betamethasone Valerate], valerato de betametasona (producto), valerato de betametasona (sustancia), valerato de betametasona, Flubenisolonvalerato
Portuguese 17-Valerato de Betametasona, Not Translated[Betamethasone Valerate], Flubenisolonvalerato

Ontology: topical steroids (C2064827)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
English topical steroids (medication), topical steroids