DESONIDE CREAM

Indications

• Atopic dermatitis
• Contact dermatitis
• Psoriasis
• Seborrheic dermatitis
• Nummular eczema

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidelines.

Adults: Apply a thin layer to the affected area once or twice daily, as directed by a healthcare professional.

Mechanism of action

Desonide exerts its effects by binding to cytosolic glucocorticoid receptors, forming a complex that migrates to the nucleus and interacts with genetic elements on DNA. This interaction leads to the activation and repression of specific genes. The anti-inflammatory action is thought to result from the induction of lipocortins, proteins that inhibit phospholipase A2, ultimately reducing the production of pro-inflammatory mediators like prostaglandins and leukotrienes by preventing the release of arachidonic acid from membrane phospholipids.

Pharmacodynamics

As a corticosteroid, desonide is effective in reducing inflammation and pruritus in various skin conditions. Its action as a topical agent allows for localized treatment with minimal systemic absorption, thus reducing the risk of systemic side effects typically associated with corticosteroids.

Pharmacokinetics

Desonide is primarily applied topically, which limits its systemic absorption. When used as directed, it demonstrates rapid onset of action at the site of application. The pharmacokinetics of desonide in terms of absorption, distribution, metabolism, and excretion are less documented due to its topical use, though systemic absorption is generally low compared to systemic corticosteroids.

Adverse effects

• Burning sensation
• Itching
• Dryness
• Skin atrophy
• Striae
• Hypopigmentation

Precautions

• Avoid use on infected areas unless treated appropriately
• Use with caution in patients with a history of hypersensitivity to corticosteroids
• Long-term use may lead to systemic absorption and adrenal suppression

Pregnancy

Use during pregnancy only if the benefits outweigh the risks, as corticosteroids can potentially affect fetal development.

Breast-feeding

Desonide is excreted in breast milk; caution is advised when used by nursing mothers.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Topical cream
• Topical ointment
• Topical lotion

Mechanism of action

Like other topical corticosteroids, desonide has anti-inflammatory, antipruritic and vasoconstrictive properties. The drug binds to cytosolic glucocorticoid receptors. This complex migrates to the nucleus and binds to genetic elements on the DNA. This activates and represses various genes. However corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.

Pharmacodynamics

Desonide is a synthetic nonfluorinated corticosteroid for topical dermatologic use. The corticosteroids constitute a class of primarily synthetic steroids used topically as anti-inflammatory and antipruritic agents.