Plasma cortisol values after topical application of diflucortolone valerate (0.3%) or clobetasol propionate (0.05%) in psoriatic patients

A double-blind randomized study to compare the plasma cortisol values at both 9.00 a.m. and 12 midnight following topical application fo 10 g daily for 7 days of either diflucortolone valerate 0.3% (Nerisone Forte) ointment or clobetasol propionate 0.05% (Dermovate) ointment in 20 hospital inpatients suffering from severe psoriasis, showed that clinically both compounds behaved as potent, highly active topical preparations and caused rapid clinical improvement. Diflucortolone valerate 0.3% caused only slight and non-significant depression of mean plasma cortisols. On the other hand, clobetasol caused an immediate, persistent and statistically significant depression of the 9.00 a.m. coritsol values, which appeared to recover towards normality only on the third day after therapy had been withdrawn. the difference between these 2 compounds was found to be statistically significant (P less than 0.05). From these observations, it is concluded that diflucortolone valerate 0.3% ointment suppresses adreno-cortical function to a significantly lesser extent than clobetasol propionate 0.05% ointment.