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(22RS)-16α,17α-Butylidenedioxy-6α,9α-difluoro-.,21-dihydroxypregn-4-ene-3,20-dione ( g) was resolved into its 22R- and 22S-epimers by chromatography on a Sephadex LH-20 column (76× cm) using a n-heptane-chloroform-ethanol (20:20:1) mixture as mobile phase. The fractions 1845-2565 ml (A) and 2745-3600 ml (B) were collected and evaporated. The two products were precipitated from methylene chloride - petroleum ether. The product from fraction A (332 mg) was identified with 1 H-NMR and mass spectrometry to be (22S)-16α,17α-butylidenedioxy-6α,9α-difluoro-.,21-dihydroxypregn-4-ene-3,20-dione and the product from the B fraction (918 mg) as the 22R-epimer.

The obvious priority is immediate discontinuation of any further topical corticosteroid use. Protection and support of the impaired skin barrier is another priority. Eliminating harsh skin regimens or products will be necessary to minimize potential for further purpura or trauma, skin sensitivity, and potential infection. Steroid Atrophy [10] [11] is often permanent, though if caught soon enough and the topical corticosteroid discontinued in time, the degree of damage may be arrested or slightly improve. However, while the accompanying Telangectasias may improve marginally, the Striae is permanent and irreversible. [1]

Fluorinated steroids examples

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