Contact allergy to topical corticosteroids in children with atopic dermatitis

Foti, Caterina; Bonifazi, E.; Casulli, Claudia; Bonamonte, Domenico; Conserva, Anna; Angelini, Gianni

doi:10.1111/j.0105-1873.2005.0548d.x

Cited by 32 publications

(27 citation statements)

References 3 publications

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“…This is in accordance with some previous studies (12,18,19). Our study also shows that contact allergy is frequently missed in children with AD.…”

Section: Discussionsupporting

confidence: 94%

“…The prevalence of contact allergy in children with AD has been estimated at 14.9-64.2% (9)(10)(11)(12)(13)(14)(15)(16). Some authors claim that atopy may be regarded as a predisposing factor for the development of type IV hypersensitivity reactions (10)(11)(12), while others argue that there is no association between AD (or other atopic diseases) and an increased risk of contact sensitisation (13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

“…Many cases of contact allergy can be linked to the basic treatment of AD, namely corticosteroids and emollients (12,17). Mostly, it is a component in the emollients that has been the culprit (1).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Children with Atopic Dermatitis Should Always be Patch-tested if They Have Hand or Foot Dermatitis

Isaksson¹,

Olhardt²,

Rådehed³

et al. 2015

Acta Derm Venerol

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Atopic dermatitis is the most common chronic inflammatory disease among children in industrialised countries. Many factors influence this disease in a negative way and contact allergy is one such factor. The aim of the study was to examine the frequency of contact allergy among children with the diagnosis atopic dermatitis. Contact allergy was found in 22/82 children (26.8%), the most common from Amerchol L101 (11.0%), potassium dichromate (7.3%), and nickel sulfate (4.9%). A statistically significant difference in contact allergy frequency was demonstrated for those with hand and/or foot eczema compared to those without. Children with atopic dermatitis who suffer from hand and/or foot dermatitis should always be patch-tested to evaluate whether they have a relevant contact allergy and thus allergic contact dermatitis.

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“…This is in accordance with some previous studies (12,18,19). Our study also shows that contact allergy is frequently missed in children with AD.…”

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Children with Atopic Dermatitis Should Always be Patch-tested if They Have Hand or Foot Dermatitis

Isaksson¹,

Olhardt²,

Rådehed³

et al. 2015

Acta Derm Venerol

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“…Corticosteroid contact allergy does not seem to explain an aggravation of the dermatitis during topical treatment with corticosteroids in a significant number of patients. This is similar to the results reported by Foti et al [32]. …”

Section: Discussionsupporting

confidence: 93%

Patch Tests in Children with Suspected Allergic Contact Dermatitis: A Prospective Study and Review of the Literature

Spek

Oranje²

2008

Dermatology

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Aims: The results of patch testing in children visiting our out-patient clinic with suspected allergic contact dermatitis (ACD) were prospectively investigated and compared with those reported in the literature. A review of the literature on patch testing and ACD in children is provided. Methods: Children were patch tested using the TRUE® test, supplemented with tixocortol-17-pivalate, budesonide and 3 commonly used emollients. Supplementary patch tests were undertaken on indication. Results: Seventy-nine children (31 boys and 48 girls) were patch tested. Of the patients tested, 40 (51%) had 1 or more positive allergic patch test reactions. Twenty-two (55%) of these 40 children suffered from atopic dermatitis, 9 (23%) from hand or foot dermatitis, and 9 (23%) from other skin ailments. Nickel was the most common contact allergen, but many other common and less common allergens were noted to give positive patch tests in patients. Conclusion: Sensitization to contact allergens may begin in infancy and continue to be more common in toddlers and young children. In recalcitrant atopic dermatitis, especially at the age of 5 years and over, patch tests are indicated. Good information on preventing the development of ACD in children is useful for caregivers.

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“…With occlusion dressing, there is a heightened risk for the development of pyoderma, furunculosis and pustules. Topical steroids, ironically, have been reported to induce allergic contact dermatitis from the preservative constituent of their vehicle [29]. Tachyphylaxis (loss of effectiveness of a drug over time), although controversial, is still believed to occur with prolonged use [30].…”

Section: Adverse Effects Of Topical Steroidsmentioning

confidence: 99%

Misuse and abuse of topical steroids: implications

Nnoruka¹,

Daramola²,

Ike³

2007

Expert Review of Dermatology

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Topical steroids, having revolutionized dermatotherapy over several decades, remain the mainstay of treatment for steroid-responsive inflammatory dermatoses worldwide. Challenges, nevertheless, abound on the usage of topical steroids, particularly with their inappropriate application. Several steps and improved formulations are constantly evolving in the scientific world, aimed at addressing most of the associated adverse events. However, until the dawn of the 'ideal topical steroid', the implications of application misuse will remain significant. This review discusses the concept of 'misuse and abuse' of topical steroids, gives an overview of topical steroids, differentiates 'misuse' as opposed to 'abuse' of application of topical steroids as they occur in different settings and provides a schematic algorithm for the appropriate and optimal application of topical steroids. Consequently, this separation will allow a more accurate estimation of the burdens of these two aspects that require different solutions. 31-40 (2007) Topical glucocorticoids are the foundation of dermatotherapeutics [1], particularly for the noninfected inflammatory dermatoses, such as the eczemas and dermatitis. Their availability since 1952 has marked the most important milestone in dermatology to date [2,3]. Although the 'ideal' topical steroids have not yet been synthesized, topical administration of steroids still remains the safest mode of administration for glucocorticoids.Topical steroids are derivatives of the prototype hydrocortisone, a natural glucocortico steriod of the adrenal cortex. Chemical substitutions at certain key positions of the cyclopentanophenathrene nucleus, altering both its glucocorticoid and mineralocorticoid properties, affects the potency of these drugs. For example, halogenation at the 9-α position enhances the potency by improving activity within the target cell and decreasing breakdown into inactive metabolites [4], while masking or removing the hydrophilic 17-dihydroxyacetone side chain or the 16 α-hydroxy group increases the lipophilicity of the molecule, thereby enhancing penetration through the stratum corneum [1,5].The existence of a reservoir within the stratum corneum for most topical xenobiotics, particularly topical steroids [6,7], affects the choice of application frequency and the dose, while percutaneous absorption is dependent on the intrinsic property of the steroid, the vehicle used, the anatomical site, age of patient and method of application (i.e., under occlusion or hydration). However, individual variation in percutaneous absorption can also be quite pronounced. All of these factors must be taken into account when considering the potential for undesirable effects of topical steroids.Abuse of steroids could be regarded as the use of steroids to achieve purposes other than a therapeutic one, while misuse of steroids can be regarded as the inappropriate use of steroids for therapeutic purposes. These terms are introduced in this article for the purpose of describing the inapt use of prescr...

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Contact allergy to topical corticosteroids in children with atopic dermatitis

Cited by 32 publications

References 3 publications

Children with Atopic Dermatitis Should Always be Patch-tested if They Have Hand or Foot Dermatitis

Children with Atopic Dermatitis Should Always be Patch-tested if They Have Hand or Foot Dermatitis

Patch Tests in Children with Suspected Allergic Contact Dermatitis: A Prospective Study and Review of the Literature

Misuse and abuse of topical steroids: implications

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