What conditions is fluocinonide indicated for?

Indications for Fluocinonide

Fluocinonide is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. 1

Primary Indications

• Fluocinonide 0.05% (cream, gel, and ointment) is FDA-approved for treating inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses 1
• As a class II (potent) topical corticosteroid, fluocinonide is effective for treating various dermatological conditions including:
  • Psoriasis 2
  • Eczematous dermatitis 3, 4
  • Atopic dermatitis 5
  • Lichen planus and lichenoid diseases 2, 6

Use in Psoriasis

• Fluocinonide is recommended for the treatment of mild to moderate psoriasis 2
• A 12-week randomized controlled trial showed that fluocinonide 0.1% cream had comparable efficacy to tazarotene 0.1% gel for plaque psoriasis 2
• Can be used in combination with vitamin D analogues for enhanced efficacy in psoriasis treatment 2
• For scalp psoriasis, fluocinonide can be considered when other treatments are not suitable 2

Use in Lichen Planus and Lichenoid Diseases

• The National Comprehensive Cancer Network recommends high-potency topical corticosteroids, including fluocinonide 0.05%, as first-line treatment for oral lichen planus 2, 6
• For immune checkpoint inhibitor-related psoriasis and psoriasiform diseases, fluocinonide 0.05% is recommended as a high-potency topical steroid option 2
• Gel formulations are preferred for mucosal disease 6

Use in Atopic Dermatitis

• Short-term intensive treatment with fluocinonide cream has shown significant improvement in atopic dermatitis symptoms 5
• A study demonstrated that a 3-day course of fluocinonide cream 0.05% resulted in 76% improvement in eczema area and severity index scores 5
• Adherence to treatment is excellent with short-course therapy 5

Dosing and Administration

• Typically applied 1-2 times daily to affected areas 3
• For moderate to severe conditions, some studies have used three times daily application 7
• Short-term intensive therapy (3-day course) has shown high efficacy and adherence in atopic dermatitis 5
• Treatment duration should be limited due to potential side effects of prolonged topical corticosteroid use 2

Limitations and Precautions

• Class I corticosteroids (including fluocinonide) should generally be limited to 2-4 weeks of continuous use due to increased risk of cutaneous side effects and systemic absorption 2
• Tachyphylaxis (decreased effectiveness with continued use) may occur with prolonged treatment 2
• Should be used cautiously on steroid-sensitive sites such as the face and intertriginous areas 2
• Gradual reduction in frequency of usage is recommended following clinical response 2

Comparative Efficacy

• In comparative studies, fluocinonide has shown:
  • Comparable efficacy to betamethasone when applied once daily versus twice daily in eczema and psoriasis 3
  • Inferior efficacy to clobetasol propionate in both psoriasis and eczema 7
  • Similar efficacy to other potent topical corticosteroids for various dermatoses 4

Fluocinonide remains an important option in the dermatological armamentarium as a potent topical corticosteroid for various inflammatory skin conditions, particularly when medium to high potency is required for adequate disease control.