The cosyntropin (ACTH1-24) laboratory test can evaluate patients for HPA axis suppression. HPA function can be reversed after the cessation of treatment or replacement with another less potent corticosteroid. If glucocorticosteroid insufficiency occurs, supplemental systemic corticosteroids may be required. Side effects of desonide requiring immediate contact with the prescribing physician:

Blistering, burning, crusting, dryness, or flaking of the skin
burning, itching, redness, skin rash, swelling, or soreness at the application site
flushing or redness of the skin
irritation
itching, scaling, severe redness, soreness, or swelling of the skin
peeling of the skin
raised, dark red, wart-like spots on the skin, especially when used on the face
stinging and burning
unusually warm skinSide effects that may go away as the body adjusts to the medication:

Body aches or pain
chills
cough
difficulty with breathing
ear congestion
fever
headache
loss of voice
nasal congestion
runny nose
sneezing
sore throat
unusual tiredness or weakness

Pregnancy
The FDA has labeled desonide as pregnancy category C. Desonide should only be used during pregnancy when absolutely necessary. Breastfeeding
It is currently unknown whether topical application of Desonide can pass into breast milk. Similar drugs taken orally have been seen to pass into breast milk. The prescribing doctor should be consulted prior to breast-feeding. Mechanism of action
Desonide is a synthetic nonfluorinated corticosteroid; topical corticosteroids have anti-inflammatory, antipruritic, and vasoconstrictive properties. The mechanism of these properties, however, is unclear for the dermal route of administration. Following absorption through the skin, corticosteroids follow pharmacokinetic pathways similarly to intravenously administered corticosteroids. The mechanism of corticosteroids is thought to induce phospholipase A2 inhibitory proteins (lipocortins). Lipocortins control the biosynthesis of inflammation mediators, like prostaglandins and leukotrienes.
Pneumoperitoneum is pneumatosis (abnormal presence of air or other gas) in the peritoneal cavity, a potential space within the abdominal cavity. The most common cause is a perforated abdominal organ, generally from a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma. A perforated appendix seldom causes a pneumoperitoneum. Spontaneous pneumoperitoneum is a rare case that is not caused by an abdominal organ rupture. This is also called an idiopathic spontaneous pneumoperitoneum when the cause is not known. In the mid-twentieth century, an "artificial" pneumoperitoneum was sometimes intentionally administered as a treatment for a hiatal hernia. This was achieved by insufflating the abdomen with carbon dioxide. The practice is currently used by surgical teams in order to aid in performing laparoscopic surgery. Causes
Perforated duodenal ulcer – The most common cause of rupture in the abdomen. Especially of the anterior aspect of the first part of the duodenum. Perforated peptic ulcer
Bowel obstruction
Ruptured diverticulum
Penetrating trauma
Ruptured inflammatory bowel disease (e.g., megacolon)
Necrotising enterocolitis/pneumatosis coli
Bowel cancer
Ischemic bowel
Steroids
After laparotomy
After laparoscopy
Breakdown of a surgical anastomosis
Bowel injury after endoscopy
Peritoneal dialysis (PD), although the prevalence of pneumoperitoneum is estimated to be less than 4% among people with PD in a more recent study in the United Kingdom. Vaginal insufflation (air enters via the fallopian tubes; e.g., water-skiing, oral sex)
Colonic or peritoneal infection
From chest (e.g., bronchopleural fistula)
Non-invasive PAP (positive airway pressure) can force air down duodenum as well as down trachea.