Which corticosteroid would be MOST appropriate for a patient with dermatitis requiring a high-potency topical agent to avoid hypothalamic-pituitary-adrenal (HPA) axis suppression with prolonged use?

• A Betamethasone valerate (Group II, high potency)
• B Hydrocortisone 1% (Group VII, lowest potency)
• C Clobetasol propionate (Group I, super-potent, highest HPA suppression risk)
• D Mometasone furoate (Group II-III, with ester structure reducing systemic absorption and HPA suppression) ✓

Explanation

Mometasone furoate and fluticasone propionate are designed with an ester structure that undergoes rapid inactivation ('soft steroids') after systemic absorption, providing high topical anti-inflammatory potency with minimal systemic bioavailability and low HPA axis suppression—making them preferable for extended therapy or sensitive areas. Clobetasol propionate is the most potent (Group I in US classification) and has the highest HPA suppression risk; it should be used sparingly and for short periods. Hydrocortisone 1% is too weak for moderate-severe dermatitis.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.