Problems in selection of topical anti-inflammatory corticosteroids.

Desonide, a non-fluorinated topical corticosteroid (16-alpha-hydroxyprednisolone acetonide), is compared with its fluorinated analogue, triamcinolone acetonide, as to vasoconstriction ability and epidermal penetration rate. Clinical effectiveness of desonide is further assessed by means of a double-blind paired comparison with an accepted potent fluorinated steroid, betamethasone 17-valerate. It is demonstrated that fluorination of the steroid molecule is not necessary to achieve potent topical anti-inflammatory effect. Vasoconstriction and epidermal penetration are not enhanced by fluorination in the drugs studied.