B. Clobetasone butyrate 0.05% – Explanation
Topical steroids
- moderate: Clobetasone butyrate 0.05%
- potent: Betamethasone valerate 0.1%
- very potent: Clobetasol propionate 0.05%
Clobetasone butyrate 0.05% is a moderately potent topical steroid and would be the most suitable
next step in management. It is important to note the potency difference between two very similar
sounding steroids – Clobetasone butyrate 0.05% (moderate) and Clobetasol propionate 0.05% (very
potent)
Eczema: topical steroids
Use weakest steroid cream which controls patients symptoms
The table below shows topical steroids by potency
| Mild | Moderate | Potent | Very potent |
| Hydrocortisone 0.5- 2.5% |
Betamethasone valerate 0.025% (Betnovate RD) Clobetasone butyrate 0.05% (Eumovate) |
Fluticasone propionate 0.05% (Cutivate) Betamethasone valerate 0.1% (Betnovate) |
Clobetasol propionate 0.05% (Dermovate) |
Finger tip rule
- 1 finger tip unit (FTU) = 0.5 g, sufficient to treat a skin area about twice that of the flat of an adult
hand
Topical steroid doses for eczema in adults
| Area of skin | Fingertip units per dose |
| Hand and fingers (front and back) | 1.0 |
| A foot (all over) | 2.0 |
| Front of chest and abdomen | 7.0 |
| Back and buttocks | 7.0 |
| Face and neck | 2.5 |
| An entire arm and hand | 4.0 |
| An entire leg and foot | 8.0 |
The BNF makes recommendation on the quantity of topical steroids that should be prescribed for an
adult for a single daily application for 2 weeks:
| Area | Amount |
| Face and neck | 15 to 30 g |
| Both hands | 15 t |
| Scalp | 15 to 30 g |
| Both arms | 30 to 60 g |
| Both legs | 100 g |
| Trunk | 100 g |
| Groin and genitalia | 15 to 30 g |
