Allergic cutaneous reactions to systemic corticosteroids

Abstract

Contact allergic reactions to topical corticosteroids are common. Cutaneous hypersensitivity reactions to systemically administered corticosteroids might occur though less frequently. The purpose of this literature review is to examine reported cases of cutaneous reactions to systemically administered corticosteroids. The data are presented considering route of administration, type of drug, type of reaction, and testing results. Corticosteroid classifications, cross-reactions, and allergy testing methods are also discussed.

Acute Urticaria Induced by Oral Methylprednisolone

“…Allergic reactions can occur via intramuscular, intraarticular, intralesional, oral, inhalational, and intravenous routes. Reactions to oral corticosteroids have been documented most commonly with prednisolone, but not with prednisone, betamethasone, triamcinolone, or methylprednisolone 2. The present case is, to our knowledge, the first case of acute generalized urticaria caused by oral methylprednisolone.…”

“…However, these tests suffer from low sensitivity and there is no consensus concerning the most effective concentrations or vehicles to be used for skin testing. The most reliable method is a provocation test of the suspected systemic corticosteroid 2. Possible cross-reactivities among hydrocortisone, methylprednisolone, and prednisone have been suggested 14.…”

“…The most reliable method is a provocation test of the suspected systemic corticosteroid. 2 Possible cross-reactivities among hydrocortisone, methylprednisolone, and prednisone have been suggested. 14 Avoidance of hydrocortisone, methylprednisolone, and prednisone in any formulation in patients displaying allergic reaction to systemic steroids has been recommended 1 .…”