Diflorasone

Diflorasone Brand Names

Apexicon | Apexicon E | Florone | Maxiflor | Psorcon | Psorcon E

What is Diflorasone

Diflorasone is a high potency, topical, fluorinated corticosteroid. Diflorasone is used to relieve the inflammatory and pruritic manifestations of moderate to severe corticosteroid-responsive dermatoses and psoriasis.

Diflorasone has also been used in the treatment of lichen sclerosus and mycosis fungoides.

Diflorasone is available in two different formulations. Very high potency (e.g. Florone E®, Psorcon E®) diflorasone is available in an emollient cream and ointment and is comparable in efficacy to betamethasone dipropionate and topical clobetasol.

High potency diflorasone (e.g. Florone®, Maxiflor®) is available in a regular cream or ointment formulation and is comparable to amcinonide, fluocinonide and betamethasone dipropionate.

Long-term or extensive use can lead to systemic side effects, including hypothalamic-pituitary-adrenal (HPA) axis suppression.

Diflorasone was approved by the FDA in 1977.

Indications

1. alopecia
2. atopic dermatitis
3. contact dermatitis
4. cutaneous T-cell lymphoma (CTCL)
5. dermatitis
6. discoid lupus erythematosus
7. eczema
8. exfoliative dermatitis
9. granuloma annulare
10. keloids
11. lichen planus
12. lichen sclerosus
13. lichen simplex
14. lichen striatus
15. mycosis fungoides
16. necrobiosis lipoidica diabeticorum
17. pemphigus
18. pityriasis rosea
19. pruritus
20. psoriasis
21. Rhus dermatitis
22. sarcoidosis
23. sunburn
24. urticaria

Side Effects

1. acneiform rash
2. adrenocortical insufficiency
3. cataracts
4. contact dermatitis
5. Cushing’s syndrome
6. erythema
7. folliculitis
8. glycosuria
9. growth inhibition
10. headache
11. hyperglycemia
12. hypertension
13. hypertrichosis
14. hypothalamic-pituitary-adrenal (HPA) suppression
15. impaired wound healing
16. increased intracranial pressure
17. infection
18. maculopapular rash
19. miliaria
20. ocular hypertension
21. papilledema
22. pruritus
23. pseudotumor cerebri
24. purpura
25. skin atrophy
26. skin hypopigmentation
27. skin irritation
28. skin ulcer
29. striae
30. telangiectasia
31. tolerance
32. visual impairment
33. withdrawal
34. xerosis

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• acne rosacea
• acne vulgaris
• breast-feeding
• cataracts
• children
• corticosteroid hypersensitivity
• Cushing’s syndrome
• diabetes mellitus
• fungal infection
• geriatric
• glaucoma
• growth inhibition
• herpes infection
• hypothalamic-pituitary-adrenal (HPA) suppression
• increased intracranial pressure
• infants
• infection
• measles
• neonates
• occlusive dressing
• ocular exposure
• ophthalmic administration
• perioral dermatitis
• peripheral vascular disease
• pregnancy
• skin abrasion
• skin atrophy
• tuberculosis
• varicella
• viral infection

Interactions

• Metyrapone

Metyrapone: (Major) Medications which affect pituitary or adrenocortical function, including all corticosteroid therapy, should be discontinued prior to and during testing with metyrapone.

Patients taking inadvertent doses of corticosteroids on the test day may exhibit abnormally high basal plasma cortisol levels and a decreased response to the test. Although systemic absorption of topical corticosteroids is minimal, temporary discontinuation of these products should be considered if possible to reduce the potential for interference with the test results.