Fluticasone propionate in the treatment of inflammatory dermatoses

Fluticasone propionate is a new, topically active glucocorticoid which shows high specificity for the glucocorticoid receptor. After topical application systemic absorption is low. The small amount that is absorbed is rapidly and completely inactivated by esterase-catalysed hydrolysis in the liver. Even when applied in large doses under occlusion, there is no evidence of hypothalamic/pituitary/adrenal (HPA) axis suppression. Studies on skin thinning have shown no significant effect on skin thickness after once-daily application of fluticasone propionate 0.05% cream for 8 weeks. This cream has been shown to be highly effective in the treatment of eczema, and once-daily application shows no significant difference in efficacy compared with twice-daily treatment. Limited studies using 0.005% ointment in moderate to severe psoriasis showed similar efficacy to 0.1% betamethasone-17-valerate ointment. Fluticasone propionate 0.05% thus represents a major advance in topical corticosteroids. It has a high safety profile and the cream formulation is effective in a single daily application.