Contact allergy to corticosteroids: A frequently missed diagnosis?

Dooms‐Goossens, A.; Degreef, Hugo; Mariën, K.; Coopman, Serge A.

doi:10.1016/s0190-9622(89)70222-x

Cited by 81 publications

(37 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The two cortico steroids in ethanol were replaced every second month, because in a preliminary study a rapid degradation of the active molecule up to 40-60% of the original concentration was found, as measured by high-pressure liquid chromatography (data not shown). Substances, concentrations and vehicles were chosen according to the results of previous studies [7,[11][12][13]. Test substances were either obtained from the Department of Dermatochemistry, University of Strasbourg, France (TXP) and prepared by the Hospital Pharmacy.…”

Section: Methodsmentioning

confidence: 99%

Contact Hypersensitivity to Corticosteroids in Routine Patch Test Patients

Bircher

Thürlimann²,

Hunziker³

et al. 1995

Dermatology

View full text Add to dashboard Cite

Background: Contact hypersensitivity to corticosteroids is increasingly reported and has been identified as a problem of considerable clinical relevance. The prevalence of positive patch tests to corticosteroids ranges from 0.2 up to 5%. Objective: The prevalence of positive patch tests to corticosteroids in Switzerland was determined in a multi-centre study of patients undergoing routine patch tests. Methods: As representatives of corticosteroid groups, the following substances were used for screening: tixocortol pivalate and hydrocortisone for group A (hydrocortisone type), hydrocortisone butyrate for group D (hydrocortisone butyrate type) and budesonide for both groups B (triamcinolone type) and D. Patients positive for at least one corticosteroid were retested with the screening series and 12 corticosteroids commonly used in Switzerland. Results: Among 3,016 consecutive patients, 65 individuals (2.2%) with a total of 106 positive reactions were found. Retesting showed a concordance of 70-98%, depending on the corticosteroid and the score of the positive reaction. In the subsequently tested corticosteroid series including 12 substances, 19 out of 56 screening-positive patients had a positive result to one or several corticosteroids. There were only few evident cross-reactive patterns in between the corticosteroids tested. Conclusions: Corticosteroids should be included in routine patch testing, because contact sensitization to a corticosteroid is of considerable practical importance. We confirm that as markers of corticosteroid sensitization tixocortol pivalate, budesonide and hydrocortisone butyrate may be suited, because there is no single corticosteroid which is a marker for all four corticosteroid groups. Patch test reactions of 2+ or higher have a better reproducibility than 1 + reactions.

show abstract

Section: Methodsmentioning

confidence: 99%

Contact Hypersensitivity to Corticosteroids in Routine Patch Test Patients

Bircher

Thürlimann²,

Hunziker³

et al. 1995

Dermatology

View full text Add to dashboard Cite

show abstract

“…They were found to be the seventh most common allergen after nickel sulphate, cobalt chloride, colophony, fragrance mix, balsam of Peru and potassium dichromate. Several problems are combined with the identification of a contact allergy to corticosteroids: the clinical picture is often misleading, the patch test procedure is a subject of discussion and the diagnosis is probably not considered often enough because clinicians were rarely aware of such a possible adverse effect [39]. Concerning treatment options, non-fluorinated corticosteroids might be more likely to induce a contact allergy than fluorinated steroids since they react more rapidly with arginine than fluorinated steroids, thus inducing sensitization [40].…”

Section: Eyelid/periorbital Dermatoses and Contact Allergymentioning

confidence: 99%

Safety and Efficacy of Fluticasone Propionate in the Topical Treatment of Skin Diseases

Roeder

Schaller

Schäfer‐Korting

et al. 2004

Skin Pharmacol Physiol

View full text Add to dashboard Cite

Fluticasone propionate – the first carbothioate corticosteroid – has been classified as a potent anti-inflammatory drug for dermatological use. It is available as 0.05% cream and 0.005% ointment formulations for the acute and maintenance treatment of patients with dermatological disorders such as atopic dermatitis, psoriasis and vitiligo. This glucocorticoid is characterized by high lipophilicity, high glucocorticoid receptor binding and activation, and a rapid metabolic turnover in skin. Although skin blanching following fluticasone propionate exceeds that of corticosteroids of medium strength, several clinical trials demonstrate a low potential for cutaneous and systemic side-effects, even in difficult-to-treat areas like the face, the eyelids and intertriginous areas. Even among paediatric patients with atopic dermatitis, fluticasone propionate proved to be safe and effective. These pharmacological and clinical properties are reflected by the high therapeutic index of this glucocorticoid.

show abstract

“…Selbstverständlich können nicht alle Patienten mit hartnäckigen therapierefraktären, sonst aber steroidsensi tiven Zuständen auf alle möglichen topischen Kortikoste roide getestet werden [2], Eine Art Markerfunktion scheint aber Tixocortol-pivalat zu haben [1], welches jedoch bei Patient 1 in den Epikutantestungen negativ blieb. Tixocortol-pivalat hat, in Nasensprays angewandt, vor allem in Frankreich und Belgien zu zahlreichen Sensi bilisierungen geführt.…”

Section: Fallbeschreibungenunclassified

“…Sie werden oft verkannt oder als fehlendes Ansprechen auf die Therapie fehlinterpretiert [1,2], da selbst bei einer Sensibilisierung aufgrund des antiinflam matorischen Effekts die Epikutantestungen zum Nach weis einer Kontaktsensibilisierung oft negativ ausfallen [3]. Bereits 2 Jahre nach Einführung von topischen Korti kosteroiden wurde über eine Kontaktallergie berichtet [4], aber erst in der neueren Literatur wird dieser Problematik vermehrt Beachtung geschenkt.…”

unclassified

Allergische Kontaktdermatitis auf das Kortikosteroid Budesonid nach intranasaler Anwendung

Hürlimann¹,

Schmid‐Grendelmeier²,

Elsner³

et al. 1994

Otorhinolaryngol Nova

View full text Add to dashboard Cite

Kontaktallergien auf topisch angewendete Kortikosteroide sind wahrscheinlich häufiger, als angenommen wird. Anhand von zwei Kasuistiken soil auf die Problematik der Sensibilisierung auf Kortikosteroide eingegangen werden. Bei einem 43jährigen Patienten mit allergischer Rhinokonjunktivitis und Pharyngitis bei Sensibilisierung auf Hausstaub- und Vorratsmilben und bei einer 27jährigen Patientin mit nichtallergischer Rhinitis kam es nach topischer Behandlung mit einem budesonidhaltigen Nasenspray zu ekzematösen Hautveränderungen im Bereiche des Gesichts und des Halses sowie zu Ekzemstreuherden an anderen Körperstellen. Mittels Epikutantestungen konnte eine Sensibilisierung vom Spättyp auf Budesonid und beim 43jährigen Patienten ausserdem eine Kreuzreaktion auf Amcinonid nachgewiesen werden.

show abstract

Contact allergy to corticosteroids: A frequently missed diagnosis?

Cited by 81 publications

References 10 publications

Contact Hypersensitivity to Corticosteroids in Routine Patch Test Patients

Contact Hypersensitivity to Corticosteroids in Routine Patch Test Patients

Safety and Efficacy of Fluticasone Propionate in the Topical Treatment of Skin Diseases

Allergische Kontaktdermatitis auf das Kortikosteroid Budesonid nach intranasaler Anwendung

Contact Info

Product

Resources

About