Desonide (Desonate) is a low-potency topical corticosteroid used to treat topical skin conditions such as eczema and steroid-responsive skin conditions.

Desonide Uses:

• Atopic dermatitis (foam and gel):
  • It is used to treat patients with atopic dermatitis who have mild to moderate disease and are aged 3 months or more.
• Corticosteroid-responsive dermatoses (ointment, cream, and lotion):
  • It is recommended for the symptomatic relief of pruritis and itching in those with eczema that responds to corticosteroids.

Desonide (Desonate) Dose in Adults

Desonide (Desonate) Dose in the treatment of Atopic dermatitis:

• Topical: Gel, foam: Use sparingly 2x daily. Once control is achieved, therapy should be stopped. If there is no improvement within four weeks, it may be necessary to reassess the diagnosis. Treatment should not last more than 4 weeks.

Desonide (Desonate) Dose in Dermatoses Responsive to Corticosteroids:

• Cream, lotion, or ointment: Apply 2 to 3x daily (2 to 4 times with Tridesilon cream) sparingly. Once control is achieved, therapy should be stopped. If there is no improvement within two weeks, it may be necessary to reassess the diagnosis.

Dose in Children:

Refer to adults' dosing.   

Pregnancy Risk Category: C

• It has not been studied in human pregnancies.

Desonide use during breastfeeding:

• It is unknown if desonide is found in breast milk after topical application. Systemically administered corticosteroids are excreted from breast milk.
• According to the manufacturer of the product, when deciding whether to continue or stop breastfeeding during therapy, it should consider the risks to infant exposure, the benefits to the infant, and the benefits to the mother. Topical corticosteroids can generally be used.
• You should not apply any topical corticosteroids at the breast until breastfeeding stops; hypertension has been reported in breastfed infants when a high-potency topical corticosteroid is applied to the nipple.   

Dose in Kidney Disease:

No dosage adjustment has been provided in the manufacturer's labeling.   

Dose in Liver disease:

The manufacturer has not recommended any adjustment in the dose.   

Desonide (Desonate) Side effects:

• Cardiovascular:
  • Hypertension
• Central nervous system:
  • Headache
  • Irritability
• Endocrine & metabolic:
  • HPA-axis suppression
  • Hyperglycemia
• Infection:
  • Increased susceptibility to infection
• Dermatologic:
  • Pruritus
  • Skin rash
  • Erythema (transient, intense)
  • Exfoliation of skin
  • Telangiectasia
  • Xeroderma
• Local:
  • Application site:
    • Atrophic striae
    • Dermatitis
    • Dyschromia
    • Local irritation
    • Local pruritus
    • Localized burning
    • Skin atrophy
    • Stinging of the skin
• Respiratory:
  • Asthma
  • Cough
  • Pharyngitis
  • Upper respiratory tract infection

Contraindications to Desonide (Desonate):

Hypersensitivity to any ingredient of the formulation or desonide.

Verdeso:

• The manufacturer's labeling does not list any contraindications.
• There is not much evidence of cross-reactivity between corticosteroids and allergenic corticosteroids. 
• Cross-sensitivity is possible due to similarities in chemical structure or pharmacologic effects.

Warnings and precautions

Suppression of the adrenals:

• Especially in younger children or individuals getting large dosages for extended periods of time, may result in hypercortisolism or suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
• Suppression of the HPA axis may cause an adrenal crisis.

Kaposi Sarcoma:

• Kaposi sarcoma can be caused by prolonged treatment with corticosteroids (case reports); discontinuation of therapy should always be considered.

Contact dermatitis:

• Allergy contact dermatitis may occur. It is often diagnosed by the failure of healing rather than clinical exacerbation. If irritation does occur, discontinue use and treat as appropriate.

Local effects:

• Localized adverse responses might happen (e.g., skin atrophy and telangiectasias; burning, itching, dryness, folliculitis, Hypopigmentation, Perioral dermatitis, Allergic contact dermatitis, Secondary infection, and miliaria).
• The likelihood of local adverse responses increases with extended and occlusive usage.

Skin infections

• Stop treatment if you have skin disorders that cannot be treated with antimicrobials.

Ocular effects

• Subcapsular and posterior subcapsular cataracts may become more common while using topical corticosteroids such as desonide.
• Keep an eye out for ocular problems.
• Limit your eye contact.

Systemic effects

• It is possible for topical corticosteroids to enter the body through the skin.
• Topical corticosteroids can absorb into the body and cause Cushing syndrome, hyperglycemia, or glycosuria.
• You can use the foam to suppress your immune system for more than four weeks.
• Absorption can be increased by using occlusive dressings or applying corticosteroids to broad regions of the skin.

Desonide: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitoring parameters:

• Track the suppression of the HPA axis (ACTH stimulation test, AM plasma cortisol test, urinary free cortisol test)
• Keep an eye out for any indications of a bacterial or fungal illness.
• Watch for any eye problems.

How to administer Desonide (Desonate)?

• It is only for topical use. 
• Use desonide on the skin by rubbing it in your hands.
• For other areas, you can apply desonide directly to the affected area.
• If the treatment area includes hands, wash your hands immediately afterwards. 
• Use sparingly and only apply the smallest amount to cover open wounds.
• Diaper dermatitis should not be treated with occlusive dressings.
• Keep your distance from your eyes and other mucous membranes.

Gel

• Should not be applied to the underarms or groin of children.   

Foam, lotion:

• Make sure to shake well before using. 
• Invert the can upside-down to dispense.
• Propeller will be lost if it is actuated upright. 
• Foam is highly flammable.
• Patients shouldn't smoke right away or while the foam is being applied.

Mechanism of action of Desonide (Desonate):

• The anti-inflammatory, anti-pruritic, and vasoconstrictive effects of topical corticosteroids are well-known.
• Reduced generation, release, and activity of endogenous chemical mediators may result from activation of the phospholipase A inhibitory protein (lipocortins), which then inhibits the release of arachidonic acid (kinins and histamines, liposomal enzymes, and prostaglandins).
• It can reduce the production, activity, and activity of inflammogenic endogenous substances (kinins and histamines, liposomal enzymes and prostaglandins).
• Desonide is a corticosteroid of modest potency.

Absorption:

• Depending on the composition, the dosage, and the kind of skin is applied. Inflammation may cause it to rise or fall.

Excretion:

• Primarily urine and Bile    ​​​​​​​

Metabolism:

• Hepatic

International Brand Names of Desonide:

• Desonate
• DesOwen
• LoKara
• Tridesilon
• Verdeso
• Desocort
• PDP-Desonide
• Adinos
• Apolar
• Calacort
• Dermades
• Dermanide
• Dermonide
• Dermosupril
• Desoclin
• Desofective
• Desolex
• Desonia
• Desotop
• Desowen
• DesOwen
• Desowon Lotion
• Despruderm
• Dong Koo Dermo Lotion
• Dosetil
• Ezenide
• Li Yan Zhuo
• Locapred
• Locatop
• Locopres
• Maxiderm
• Prenacid
• Reticus
• Sterax
• Topifug
• Tridesilon
• Tridesonit
• Zotinar

Desonide Brand Names in Pakistan: