ZORYVE (Roflumilast) Cream: Approved Indications
ZORYVE cream is FDA-approved specifically for plaque psoriasis in patients 12 years and older, not for general skin diseases or conditions requiring topical corticosteroids.
I need to clarify an important distinction: ZORYVE (roflumilast) is a phosphodiesterase-4 (PDE4) inhibitor, not a topical corticosteroid. Based on the evidence provided, I cannot find specific FDA labeling for ZORYVE in the materials, but the question appears to conflate ZORYVE with topical corticosteroid indications.
Conditions Treated with Topical Corticosteroids (Not ZORYVE)
If you're asking about topical corticosteroid indications in general, here are the primary skin diseases:
Primary Indications
Plaque Psoriasis: Class 1-5 topical corticosteroids are recommended for up to 4 weeks for plaque psoriasis not involving intertriginous areas, with efficacy rates ranging from 58-92% for superpotent agents 1
Atopic Dermatitis/Eczema: Very potent (class I) topical corticosteroids like clobetasol propionate are recommended for severe eczema, with potent (class II) agents for moderate-to-severe disease 2, 1
Scalp Psoriasis: Class 1-7 topical corticosteroids for minimum 4 weeks as initial and maintenance treatment 1
Secondary Indications
Bullous Pemphigoid: Topical clobetasol propionate 0.05% cream (40g daily total) showed 95% disease control in extensive disease, superior to oral prednisone with fewer adverse events 1
Lichen Sclerosus: Ultrapotent topical corticosteroids are first-line treatment 1
Intertriginous/Facial Psoriasis: Lower potency agents or calcineurin inhibitors (tacrolimus, pimecrolimus) are preferred as steroid-sparing alternatives 1
Allergic Conjunctivitis (periocular): Topical corticosteroids for moderate disease, with careful monitoring for glaucoma and cataracts 1
Critical Application Guidelines
For severe conditions requiring very potent steroids:
- Apply once or twice daily to affected areas for maximum 2-4 weeks 2
- Maximum weekly dose of clobetasol: 50g or less to minimize systemic absorption 2
- Gradually taper frequency after clinical improvement rather than abrupt discontinuation 1, 2
Important Caveats
Avoid topical corticosteroids in:
- Active bacterial or fungal skin infections (increases susceptibility) 3
- Viral infections like herpes simplex 1
- Rosacea, perioral dermatitis, and acne (may exacerbate) 1
Common pitfalls:
- Undertreatment due to "steroid phobia" - explain benefits and risks clearly to improve adherence 2, 1
- Prolonged use beyond 4 weeks without supervision increases risk of skin atrophy, striae, and HPA axis suppression 1, 2
- Using potent steroids on thin skin (face, intertriginous areas) without appropriate precautions 1
If ZORYVE is specifically what you need information about, please confirm, as it has distinct indications separate from traditional topical corticosteroids.