Diflorasone

DAE Class; Rx

Common Brand Names; Psorcon, ApexiCon, ApexiCon E

• Corticosteroids, Topical

High potency, topical, fluorinated corticosteroid
Used to treat corticosteroid-responsive dermatoses and psoriasis
Long-term or extensive use can lead to systemic side effects

Indicated for the treatment of corticosteroid-responsive dermatoses, including atopic dermatitis, localized vitiligo, eczema, phimosis, lichen planus, and localized bullous pemphigoid. 

For the treatment of psoriasis.

Dermatoses

Apply sparingly to affected area(s) qDay-q8hr; discontinue therapy when; discontinue therapy if control achieved and reassess diagnosis if no improvement within 4 weeks

Underlying infection

Hypersensitivity

Ophthalmic use

Skin atrophy

Arthralgia

Dryness

Folliculitis

Secondary infection

Striae

Pigmentation changes

HPA suppression (with higher potency used >2 wk)

Burning

Itching

Irritation

Hypertrichosis

Acneiform eruptions

Hypopigmentation

Perioral dermatitis

Allergic contact dermatitis

Maceration of the skin,

Miliaria

Postmarketing Reports

Vision Disorders: Cataract, glaucoma, central serous chorioretinopathy

Chronic topical corticosteroid therapy may interfere with growth and development in children

Use med to very high potency for <2 wk to reduce local and systemic side effects

Use low potency for chronic therapy

Kaposi’s sarcoma reported with prolonged corticosteroid therapy

Avoid medium to very high potency on face, folds, groin because can increase steroid absorption

Use lower potency for children (ie, increase BSA/kg, therefore increase systemic absorption)

Use of topical corticosteroids may increase risk of posterior subcapsular cataracts and glaucoma; cataracts reported in postmarketing experience with use of topical diflorasone diacetate products; glaucoma, with possible damage to optic nerve, and increased intraocular pressure reported in postmarketing experience with use of topical dermal corticosteroids

Avoid contact with eyes; advise patients to report any visual symptoms

Some patients, including children may exhibit susceptibility to corticosteroid-induced HPA axis suppression and Cushing’s syndrome due to prolonged use, or addition of occlusive dressings

Pediatric patients may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity

If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted

In presence of dermatological infections, institute appropriate antifungal or antibacterial; if a favorable response does not occur promptly, the discontinue corticosteroid therapy until infection has been adequately controlled

Pregnancy

Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels; more potent corticosteroids shown to be teratogenic after dermal application in laboratory animals; there are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids; topical corticosteroids should be used during pregnancy only if potential benefit justifies potential risk to fetus; drugs of this class should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time

Lactation

Not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk; because many drugs are excreted in human milk, exercise caution should when administering product to a nursing woman

Adults

50 g/week topically.

Elderly

50 g/week topically.

Adolescents

50 g/week topically.

Children

10 g/week topically.

Diflorasone