These Highlights Do Not Include All The Information Needed To Use Derma-smoothe/fs®

Pregnancy Category C: Corticosteroids have been shown to be teratogenic in laboratory animals when administered systemically at relatively low dosage levels. Some corticosteroids have been shown to be teratogenic after dermal application in laboratory animals.

There are no adequate and well-controlled studies in pregnant women on teratogenic effects from Derma-Smoothe/FS^®. Therefore, Derma-Smoothe/FS^® should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

8.4.1 Systemic Adverse Reactions in Pediatric Patients

HPA axis suppression, Cushing's syndrome, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include linear growth retardation, delayed weight gain, low plasma cortisol levels, and subnormal response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.

Because of a higher ratio of skin surface area to body mass, children are at a greater risk for systemic adverse reactions than are adults when treated with topical corticosteroids. [See Warnings and Precautions (5.1)]

Indication and Usage, Pediatric Patients with Atopic Dermatitis (1.2) 11/2007

Storage: Store at 25°C (68°-77°F); excursions permitted to 15°-30°C (59°-86°F) [See USP Controlled Room Temperature].

Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects, including under conditions of normal use. [See Warnings and Precautions (5.1) and Use in Specific Populations (8.4)].

Derma-Smoothe/FS^® (fluocinolone acetonide), Topical Oil, 0.01% (Body Oil) contains fluocinolone acetonide [(6α, 11β, 16α)-6,9-difluoro-11,21-dihydroxy-16,17 [(1-methylethylidene)bis(oxy)]-pregna-1,4-diene-3,20-dione, cyclic 16,17 acetal with acetone], a synthetic corticosteroid for topical dermatologic use.

This formulation is also marketed as Derma-Smoothe/FS^® (fluocinolone acetonide), Topical Oil, 0.01% (Scalp Oil) for use with shower caps for treatment of scalp psoriasis in adults, and as fluocinolone acetonide oil, 0.01% for treatment of chronic eczematous external otitis. Chemically, fluocinolone acetonide is C₂₄ H₃₀ F₂ O₆. It has the following structural formula:

Fluocinolone acetonide in Derma-Smoothe/FS^® has a molecular weight of 452.50. It is a white crystalline powder that is odorless, stable in light, and melts at 270°C with decomposition; soluble in alcohol, acetone and methanol; slightly soluble in chloroform; insoluble in water.

Each gram of Derma-Smoothe/FS^® contains approximately 0.11 mg of fluocinolone acetonide in a blend of oils, which contains isopropyl alcohol, isopropyl myristate, light mineral oil, oleth-2, refined peanut oil NF and fragrances.

Derma-Smoothe/FS^® is formulated with 48% refined peanut oil NF. The peanut oil used in Derma-Smoothe/FS^® is tested for peanut proteins through amino acid analysis which can detect the quantity of amino acids to below 0.5 parts per million.

• Derma-Smoothe/FS^® should be used as directed by the physician. It is for external use only. Avoid contact with the eyes. In case of contact, wash eyes liberally with water.
• Derma-Smoothe/FS^® should not be used for any disorder other than that for which it was prescribed.
• Patients should report any worsening of their skin condition to their physician promptly.
• Derma-Smoothe/FS^® should not be applied under occlusion unless directed by the physician. Derma-Smoothe/FS^® should not be applied to the diaper area as diapers or plastic pants may constitute occlusive use.
• Derma-Smoothe/FS^® should not be used on the face, axillae, or groin unless directed by the physician.
• As with other corticosteroids, therapy should be discontinued when control of disease is achieved. Contact the physician if no improvement is seen within 2 weeks.
• Do not use other corticosteroid-containing products while using Derma-Smoothe/FS^® without first consulting your physician.

None.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk.

Because many drugs are excreted in human milk, caution should be exercised when Derma-Smoothe/FS^® is administered to a nursing woman.

Topical corticosteroids can be absorbed from intact healthy skin. The extent of percutaneous absorption of topical corticosteroids is determined by many factors, including the product formulation and the integrity of the epidermal barrier. Occlusion, inflammation and/or other disease processes in the skin may increase percutaneous absorption.

The use of pharmacodynamic endpoints for assessing the systemic exposure of topical corticosteroids may be necessary due to the fact that circulating levels are often below the level of detection. Once absorbed through the skin, topical corticosteroids are metabolized primarily in the liver, and are then excreted by the kidneys. Some corticosteroids and their metabolites are also excreted in the bile.

Derma-Smoothe/FS^® is in the low to medium range of potency as compared with other topical corticosteroids in vasoconstrictor studies.

Apply the least amount of Derma-Smoothe/FS^® needed to cover the affected areas. As with other corticosteroids, Derma-Smoothe/FS^® should be discontinued when control of disease is achieved. Contact the physician if no improvement is seen within 2 weeks.

Derma-Smoothe/FS^® should not be applied to the diaper area; diapers or plastic pants may constitute occlusive use.

Derma-Smoothe/FS^® should not be used on the face, axillae, or groin unless directed by the physician. Application to intertriginous areas should be avoided due to the increased risk of local adverse reactions. [see Adverse Reactions (6) and Use in Specific Populations (8.4)].

Derma-Smoothe/FS^® is a corticosteroid indicated for the

• topical treatment of atopic dermatitis in adult patients (1.1)
• topical treatment of moderate to severe atopic dermatitis in pediatric patients 3 months and older for up to 4 weeks (1.2)

Limitations of Use:

• Apply the least amount to cover affected areas.
  
  Discontinue when disease is controlled. (1.3)
• Do not use in the diaper area. (1.3)
• Do not use on the face, axillae, or groin. (1.3, 6.2, 8.4)

Like other topical corticosteroids, fluocinolone acetonide has anti-inflammatory, antipruritic, and vasoconstrictive properties. The mechanism of the anti-inflammatory activity of the topical steroids, in general, is unclear. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.

• Topical corticosteroids can produce reversible HPA axis suppression, Cushing's syndrome, hyperglycemia, and glucosuria. (5.1)
• Systemic absorption may require evaluation for hypothalamic-pituitary-adrenal (HPA) axis suppression. (5.1)
• Modify use should HPA axis suppression develop. (5.1)
• Potent corticosteroids use on large areas, prolonged use or occlusive use may increase systemic absorption. (5.1)
• Local adverse reactions may include atrophy, striae, irritation, acneiform eruptions, hypopigmentation, and allergic contact dermatitis and may be more likely with occlusive use or more potent corticosteroids (5.2,5.3,6.1)
• Children may be more susceptible to systemic toxicity from equivalent doses. (5.1,8.4)

​PRINCIPAL DISPLAY PANEL - 118.28 mL Carton Label

NDC 68791-101-04

Rx only

​Derma-Smoothe/FS^®

​Fluocinolone Acetonide

​0.01% Topical Oil

​(Body Oil)

​FOR TOPICAL USE ONLY

​NOT FOR ORAL, OPHTHALMIC,

​or INTRAVAGINAL USE

​SHAKE WELL BEFORE USE

​Net Contents 118.28 mL

​(4 fl. oz.)

​ROYAL

​PHARMACEUTICALS^​®​

PRINCIPAL DISPLAY PANEL - 20 mL Carton Physcian Sample Label

NOT FOR SALE

PHYSICIAN SAMPLE

NDC 68791-101-01

Rx only

Derma-Smoothe/FS^®

Fluocinolone Acetonide 0.01% Topical Oil

(BODY OIL)

FOR TOPICAL USE ONLY

NOT FOR ORAL OPHTHALMIC,

OR INTRAVAGINAL USE

SHAKE WELL BEFORE USE

NET Contents: 20 mL

Royal Pharmaceuticals^®

Derma-Smoothe/FS^® is not for oral, ophthalmic, or intravaginal use.

The dosing of Derma-Smoothe/FS^® is different for adult and pediatric patients.

Derma-Smoothe/FS^® (fluocinolone acetonide), Topical Oil, 0.01% (Body Oil) is supplied in bottles containing 4 fluid ounces.

Concomitant skin infections should be treated with an appropriate antimicrobial agent. If the infection persists unchanged, Derma-Smoothe/FS^® should be discontinued until the infection has been adequately treated.

Derma-Smoothe/FS^® is supplied in bottles containing 4 fluid ounces. It is labeled as Body Oil (NDC # 68791-101-04).

Physicians should use caution in prescribing Derma-Smoothe/FS^® for peanut-sensitive individuals. [See Description (11)]

Should signs of hypersensitivity present (wheal and flare reactions, pruritus, or other manifestations), or should disease exacerbations occur, Derma-Smoothe/FS^® should be discontinued immediately and appropriate therapy instituted.

Derma-Smoothe/FS^® is indicated for the topical treatment of atopic dermatitis in adult patients.

Apply Derma-Smoothe/FS^® as a thin film to the affected areas three times daily.

Derma-Smoothe/FS^® is indicated for the topical treatment of moderate to severe atopic dermatitis in pediatric patients, 3 months and older for up to 4 weeks. Safety and effectiveness in pediatric patients younger than 3 months of age have not been established.

Moisten skin and apply Derma-Smoothe/FS^® as a thin film to the affected areas twice daily for up to four weeks.

Systemic absorption of topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for glucocorticosteroid insufficiency. Cushing's syndrome, hyperglycemia, and glucosuria can also be produced by systemic absorption of topical corticosteroids.

Because of the potential for systemic absorption, use of topical corticosteroids may require that patients be periodically evaluated for HPA axis suppression. The ACTH stimulation test may be helpful in evaluating patients for HPA axis suppression.

If HPA axis suppression is documented, an attempt should be made to withdraw the drug, to reduce the frequency of application, or to substitute a less potent corticosteroid. Recovery of HPA axis function is generally prompt upon discontinuation of topical corticosteroids.

Conditions which increase systemic absorption include the use of more potent corticosteroids, use over large surface areas, use over prolonged periods, and use of occlusive dressings. Manifestations of adrenal insufficiency may require supplemental systemic corticosteroids.

Children may be more susceptible to systemic toxicity from equivalent doses due to their larger skin surface to body mass ratios. [See Use in Specific Populations (8.4)]

Local adverse reactions may occur with use of topical corticosteroids and may be more likely to occur with occlusive use, prolonged use or use of higher potency corticosteroids. Some local adverse reactions may be irreversible. Reactions may include atrophy, striae, telangiectasias, burning, itching, irritation, dryness, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, and miliaria. [See Adverse Reactions (6.1)]

Long-term animal studies have not been performed to evaluate the carcinogenic potential or the effect on fertility of Derma-Smoothe/FS^®. Studies have not been performed to evaluate the mutagenic potential of fluocinolone acetonide, the active ingredient in Derma-Smoothe/FS^®. Some corticosteroids have been found to be genotoxic in various genotoxicity tests (i.e. the in vitro human peripheral blood lymphocyte chromosome aberration assay with metabolic activation, the in vivo mouse bone marrow micro nucleus assay, the Chinese hamster micronucleus test, and the in vitro mouse lymphoma gene mutation assay).

Allergic contact dermatitis to any component of topical corticosteroids is usually diagnosed by a failure to heal rather than a clinical exacerbation. Clinical diagnosis of allergic contact dermatitis can be confirmed by patch testing.

An open-label study was conducted in 58 children with moderate to severe atopic dermatitis (2 to 12 years old) to evaluate the safety of Derma-Smoothe/FS^® when applied to the face twice daily for 4 weeks. The following adverse reactions were reported:

An open-label safety study was conducted in 29 children to assess the HPA axis by ACTH stimulation testing following use of Derma-Smoothe/FS^® twice daily for 4 weeks. The following adverse reactions were reported in the study [See Use in Specific Populations (8.4) ];

Pregnancy Category C: Corticosteroids have been shown to be teratogenic in laboratory animals when administered systemically at relatively low dosage levels. Some corticosteroids have been shown to be teratogenic after dermal application in laboratory animals.

There are no adequate and well-controlled studies in pregnant women on teratogenic effects from Derma-Smoothe/FS^®. Therefore, Derma-Smoothe/FS^® should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

8.4.1 Systemic Adverse Reactions in Pediatric Patients

HPA axis suppression, Cushing's syndrome, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include linear growth retardation, delayed weight gain, low plasma cortisol levels, and subnormal response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema.

Because of a higher ratio of skin surface area to body mass, children are at a greater risk for systemic adverse reactions than are adults when treated with topical corticosteroids. [See Warnings and Precautions (5.1)]

Indication and Usage, Pediatric Patients with Atopic Dermatitis (1.2) 11/2007

Storage: Store at 25°C (68°-77°F); excursions permitted to 15°-30°C (59°-86°F) [See USP Controlled Room Temperature].

Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects, including under conditions of normal use. [See Warnings and Precautions (5.1) and Use in Specific Populations (8.4)].

Derma-Smoothe/FS^® (fluocinolone acetonide), Topical Oil, 0.01% (Body Oil) contains fluocinolone acetonide [(6α, 11β, 16α)-6,9-difluoro-11,21-dihydroxy-16,17 [(1-methylethylidene)bis(oxy)]-pregna-1,4-diene-3,20-dione, cyclic 16,17 acetal with acetone], a synthetic corticosteroid for topical dermatologic use.

This formulation is also marketed as Derma-Smoothe/FS^® (fluocinolone acetonide), Topical Oil, 0.01% (Scalp Oil) for use with shower caps for treatment of scalp psoriasis in adults, and as fluocinolone acetonide oil, 0.01% for treatment of chronic eczematous external otitis. Chemically, fluocinolone acetonide is C₂₄ H₃₀ F₂ O₆. It has the following structural formula:

Fluocinolone acetonide in Derma-Smoothe/FS^® has a molecular weight of 452.50. It is a white crystalline powder that is odorless, stable in light, and melts at 270°C with decomposition; soluble in alcohol, acetone and methanol; slightly soluble in chloroform; insoluble in water.

Each gram of Derma-Smoothe/FS^® contains approximately 0.11 mg of fluocinolone acetonide in a blend of oils, which contains isopropyl alcohol, isopropyl myristate, light mineral oil, oleth-2, refined peanut oil NF and fragrances.

Derma-Smoothe/FS^® is formulated with 48% refined peanut oil NF. The peanut oil used in Derma-Smoothe/FS^® is tested for peanut proteins through amino acid analysis which can detect the quantity of amino acids to below 0.5 parts per million.

• Derma-Smoothe/FS^® should be used as directed by the physician. It is for external use only. Avoid contact with the eyes. In case of contact, wash eyes liberally with water.
• Derma-Smoothe/FS^® should not be used for any disorder other than that for which it was prescribed.
• Patients should report any worsening of their skin condition to their physician promptly.
• Derma-Smoothe/FS^® should not be applied under occlusion unless directed by the physician. Derma-Smoothe/FS^® should not be applied to the diaper area as diapers or plastic pants may constitute occlusive use.
• Derma-Smoothe/FS^® should not be used on the face, axillae, or groin unless directed by the physician.
• As with other corticosteroids, therapy should be discontinued when control of disease is achieved. Contact the physician if no improvement is seen within 2 weeks.
• Do not use other corticosteroid-containing products while using Derma-Smoothe/FS^® without first consulting your physician.

None.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk.

Because many drugs are excreted in human milk, caution should be exercised when Derma-Smoothe/FS^® is administered to a nursing woman.

Topical corticosteroids can be absorbed from intact healthy skin. The extent of percutaneous absorption of topical corticosteroids is determined by many factors, including the product formulation and the integrity of the epidermal barrier. Occlusion, inflammation and/or other disease processes in the skin may increase percutaneous absorption.

The use of pharmacodynamic endpoints for assessing the systemic exposure of topical corticosteroids may be necessary due to the fact that circulating levels are often below the level of detection. Once absorbed through the skin, topical corticosteroids are metabolized primarily in the liver, and are then excreted by the kidneys. Some corticosteroids and their metabolites are also excreted in the bile.

Derma-Smoothe/FS^® is in the low to medium range of potency as compared with other topical corticosteroids in vasoconstrictor studies.

Apply the least amount of Derma-Smoothe/FS^® needed to cover the affected areas. As with other corticosteroids, Derma-Smoothe/FS^® should be discontinued when control of disease is achieved. Contact the physician if no improvement is seen within 2 weeks.

Derma-Smoothe/FS^® should not be applied to the diaper area; diapers or plastic pants may constitute occlusive use.

Derma-Smoothe/FS^® should not be used on the face, axillae, or groin unless directed by the physician. Application to intertriginous areas should be avoided due to the increased risk of local adverse reactions. [see Adverse Reactions (6) and Use in Specific Populations (8.4)].

Derma-Smoothe/FS^® is a corticosteroid indicated for the

• topical treatment of atopic dermatitis in adult patients (1.1)
• topical treatment of moderate to severe atopic dermatitis in pediatric patients 3 months and older for up to 4 weeks (1.2)

Limitations of Use:

• Apply the least amount to cover affected areas.
  
  Discontinue when disease is controlled. (1.3)
• Do not use in the diaper area. (1.3)
• Do not use on the face, axillae, or groin. (1.3, 6.2, 8.4)

Like other topical corticosteroids, fluocinolone acetonide has anti-inflammatory, antipruritic, and vasoconstrictive properties. The mechanism of the anti-inflammatory activity of the topical steroids, in general, is unclear. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.

• Topical corticosteroids can produce reversible HPA axis suppression, Cushing's syndrome, hyperglycemia, and glucosuria. (5.1)
• Systemic absorption may require evaluation for hypothalamic-pituitary-adrenal (HPA) axis suppression. (5.1)
• Modify use should HPA axis suppression develop. (5.1)
• Potent corticosteroids use on large areas, prolonged use or occlusive use may increase systemic absorption. (5.1)
• Local adverse reactions may include atrophy, striae, irritation, acneiform eruptions, hypopigmentation, and allergic contact dermatitis and may be more likely with occlusive use or more potent corticosteroids (5.2,5.3,6.1)
• Children may be more susceptible to systemic toxicity from equivalent doses. (5.1,8.4)

​PRINCIPAL DISPLAY PANEL - 118.28 mL Carton Label

NDC 68791-101-04

Rx only

​Derma-Smoothe/FS^®

​Fluocinolone Acetonide

​0.01% Topical Oil

​(Body Oil)

​FOR TOPICAL USE ONLY

​NOT FOR ORAL, OPHTHALMIC,

​or INTRAVAGINAL USE

​SHAKE WELL BEFORE USE

​Net Contents 118.28 mL

​(4 fl. oz.)

​ROYAL

​PHARMACEUTICALS^​®​

PRINCIPAL DISPLAY PANEL - 20 mL Carton Physcian Sample Label

NOT FOR SALE

PHYSICIAN SAMPLE

NDC 68791-101-01

Rx only

Derma-Smoothe/FS^®

Fluocinolone Acetonide 0.01% Topical Oil

(BODY OIL)

FOR TOPICAL USE ONLY

NOT FOR ORAL OPHTHALMIC,

OR INTRAVAGINAL USE

SHAKE WELL BEFORE USE

NET Contents: 20 mL

Royal Pharmaceuticals^®

Derma-Smoothe/FS^® is not for oral, ophthalmic, or intravaginal use.

The dosing of Derma-Smoothe/FS^® is different for adult and pediatric patients.

Derma-Smoothe/FS^® (fluocinolone acetonide), Topical Oil, 0.01% (Body Oil) is supplied in bottles containing 4 fluid ounces.

Concomitant skin infections should be treated with an appropriate antimicrobial agent. If the infection persists unchanged, Derma-Smoothe/FS^® should be discontinued until the infection has been adequately treated.

Derma-Smoothe/FS^® is supplied in bottles containing 4 fluid ounces. It is labeled as Body Oil (NDC # 68791-101-04).

Physicians should use caution in prescribing Derma-Smoothe/FS^® for peanut-sensitive individuals. [See Description (11)]

Should signs of hypersensitivity present (wheal and flare reactions, pruritus, or other manifestations), or should disease exacerbations occur, Derma-Smoothe/FS^® should be discontinued immediately and appropriate therapy instituted.

Derma-Smoothe/FS^® is indicated for the topical treatment of atopic dermatitis in adult patients.

Apply Derma-Smoothe/FS^® as a thin film to the affected areas three times daily.

Derma-Smoothe/FS^® is indicated for the topical treatment of moderate to severe atopic dermatitis in pediatric patients, 3 months and older for up to 4 weeks. Safety and effectiveness in pediatric patients younger than 3 months of age have not been established.

Moisten skin and apply Derma-Smoothe/FS^® as a thin film to the affected areas twice daily for up to four weeks.

Systemic absorption of topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for glucocorticosteroid insufficiency. Cushing's syndrome, hyperglycemia, and glucosuria can also be produced by systemic absorption of topical corticosteroids.

Because of the potential for systemic absorption, use of topical corticosteroids may require that patients be periodically evaluated for HPA axis suppression. The ACTH stimulation test may be helpful in evaluating patients for HPA axis suppression.

If HPA axis suppression is documented, an attempt should be made to withdraw the drug, to reduce the frequency of application, or to substitute a less potent corticosteroid. Recovery of HPA axis function is generally prompt upon discontinuation of topical corticosteroids.

Conditions which increase systemic absorption include the use of more potent corticosteroids, use over large surface areas, use over prolonged periods, and use of occlusive dressings. Manifestations of adrenal insufficiency may require supplemental systemic corticosteroids.

Children may be more susceptible to systemic toxicity from equivalent doses due to their larger skin surface to body mass ratios. [See Use in Specific Populations (8.4)]

Local adverse reactions may occur with use of topical corticosteroids and may be more likely to occur with occlusive use, prolonged use or use of higher potency corticosteroids. Some local adverse reactions may be irreversible. Reactions may include atrophy, striae, telangiectasias, burning, itching, irritation, dryness, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, and miliaria. [See Adverse Reactions (6.1)]

Long-term animal studies have not been performed to evaluate the carcinogenic potential or the effect on fertility of Derma-Smoothe/FS^®. Studies have not been performed to evaluate the mutagenic potential of fluocinolone acetonide, the active ingredient in Derma-Smoothe/FS^®. Some corticosteroids have been found to be genotoxic in various genotoxicity tests (i.e. the in vitro human peripheral blood lymphocyte chromosome aberration assay with metabolic activation, the in vivo mouse bone marrow micro nucleus assay, the Chinese hamster micronucleus test, and the in vitro mouse lymphoma gene mutation assay).

Allergic contact dermatitis to any component of topical corticosteroids is usually diagnosed by a failure to heal rather than a clinical exacerbation. Clinical diagnosis of allergic contact dermatitis can be confirmed by patch testing.

An open-label study was conducted in 58 children with moderate to severe atopic dermatitis (2 to 12 years old) to evaluate the safety of Derma-Smoothe/FS^® when applied to the face twice daily for 4 weeks. The following adverse reactions were reported:

An open-label safety study was conducted in 29 children to assess the HPA axis by ACTH stimulation testing following use of Derma-Smoothe/FS^® twice daily for 4 weeks. The following adverse reactions were reported in the study [See Use in Specific Populations (8.4) ];