These groups include: 

Those who have used topical corticosteroids over a prolonged period of time
Those who have used corticosteroids to cover a large surface area
Those with broken skin barrier or extensive abrasions
Those who have recently undergone stress (such as illness, trauma, surgery)
Children under the age of 12HPA axis suppression is preventable by supplementation with glucocorticosteroids. If HPA axis suppression occurs, it is often reversed shortly after discontinuation of treatment. Pharmacology
Mechanism of action
Pharmacokinetics
Absorption of topical corticosteroids depends on several factors such as the vehicle, or delivery system used by the drug, the integrity of the epidermal barrier, and whether or not an occlusive bandage is used in combination with the drug.The absorption of topical betamethasone dipropionate is theoretically minuscule; however, if absorbed it follows the same pharmacokinetic profile that is typical of systemic corticosteroids. It is metabolized primarily by the liver by hydrolysis to its metabolites B17P (primary) and betamethasone and the 6β-hydroxy derivatives of those metabolites, and it is excreted primarily by the kidneys. Chemistry
Betamethasone dipropionate is a white to almost white crystalline powder. Regulation
Betamethasone dipropionate was patented by Merck in 1987, as an augmented cream/lotion, Diprolene in the U.S., and Disprosone in Europe. These patents expired in 2003 and 2007 respectively leading to generic production of betamethasone dipropionate. During this time other topical corticosteroids such as triamcinolone acetonide and clobetasol propionate also became available as generic creams.
Triggers that make carbuncle infections more likely include recent incidence of folliculitis; friction from clothing or shaving; having hair pulled out, such as sites where clothing or furniture grab at hairs; generally poor hygiene; poor nutrition; or weakened immunity. Poor health may be a predisposing factor – for example, persons with diabetes and immune system diseases are more likely to develop infections (especially bacterial infections of the leg or foot). Society and culture
Etymology
The word is believed to have originated from the Latin: carbunculus, originally a small coal; diminutive of carbon-, carbo: charcoal or ember, but also a carbuncle stone, "precious stones of a red or fiery colour", usually garnets. Metaphor: the "monstrous carbuncle"
In 1984 Charles III, then Prince of Wales, described the proposed Sainsbury Wing extension to the National Gallery in London as a "monstrous carbuncle on the face of a much-loved and elegant friend", a term he has used since to describe other pieces of architecture. == References ==