![]() ![]() Infants and small children may be more susceptible to HPA axis suppression, intracranial hypertension, Cushing syndrome, or other systemic toxicities due to larger skin surface area to body mass ratio. Percutaneous absorption of topical steroids is increased in neonates (especially preterm neonates), infants, and young children. The extent of percutaneous absorption is dependent on several factors, including epidermal integrity (intact vs abraded skin), formulation, age of the patient, prolonged duration of use, and the use of occlusive dressings. Warnings: Additional Pediatric Considerations Appropriate use: Avoid use of topical preparations with occlusive dressings or on weeping or exudative lesions.Prolonged use may affect growth velocity growth should be routinely monitored in pediatric patients. HPA axis suppression, intracranial hypertension, and Cushing syndrome have been reported in children receiving topical corticosteroids. Children may absorb proportionally larger amounts after topical application and may be more prone to systemic effects. Pediatric: Not for treatment of diaper dermatitis.Older adult: Because of the risk of adverse effects associated with systemic absorption, topical corticosteroids should be used cautiously in the elderly in the smallest possible effective dose for the shortest duration. ![]() Absorption is increased by the use of occlusive dressings, application to denuded skin, or application to large surface areas. Absorption of topical corticosteroids may cause manifestations of Cushing's syndrome, hyperglycemia, or glycosuria. Systemic effects: Topical corticosteroids may be absorbed percutaneously.Ocular effects: Topical corticosteroids, including mometasone, may increase the risk of posterior subcapsular cataracts and glaucoma.Immunosuppression: Prolonged use may result in fungal or bacterial superinfection discontinue if dermatological infection persists despite appropriate antimicrobial therapy.Contact dermatitis: Allergic contact dermatitis can occur and is usually diagnosed by failure to heal rather than clinical exacerbation discontinue use if irritation occurs and treat appropriately.HPA axis suppression may lead to adrenal crisis. Adrenal suppression: May cause hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods.<1%, postmarketing, and/or case reports: Acneiform eruption, cataract, cutaneous candidiasis, glaucoma, skin depigmentation Local: Application site burning (2%), application site pruritus (≤2%)ĭermatologic: Acne rosacea, furunculosis, skin atrophy, stinging of the skin (application site) Gastrointestinal: Xerostomia (infants & children: 2%) The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.Ĭentral nervous system: Paresthesia (lotion, infants & children: ≤3%, cream, children: 1%)ĭermatologic: Dyschromia (loss of normal skin markings: ≤6%), taut and shiny skin (≤6%), folliculitis (lotion: 3% cream, children: <1%), telangiectasia (≤3%), dermatologic disorders (2%), bacterial skin infection (infants & children: ≤2%), epidermal thinning (≤2%)Įndocrine & metabolic: Decreased cortisol (infants & children: lotion: ≤6%, cream and ointment: ≤2%), endocrine disease (lotion: 2%)
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