Corticosteroid Hypersensitivity Studies in a Skin Allergy Unit

Berbegal, L.; DeLeon, F.J.; Silvestre, Juan Francisco

doi:10.1016/j.adengl.2015.10.011

Cited by 7 publications

(14 citation statements)

References 20 publications

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“…The prevalence of contact allergy to topical corticosteroids found in the present study (1.46%) is similar to previously reported values in Spain . Berbegal et al.…”

Section: Discussionsupporting

confidence: 93%

“…The prevalence of contact allergy to topical corticosteroids found in the present study (1.46%) is similar to previously reported values in Spain (14,16). Berbegal et al (14), in a single-centre retrospective study, found 1.16% of 2587 tested patients with corticosteroid contact allergy in an 11-year period.…”

Section: Discussionsupporting

confidence: 92%

“…Our corticosteroid-allergic population showed a statistically significantly higher proportion of males than the non-allergic population. Berbegal et al (14) published similar findings, in contrast to Baeck et al (13) and other previous studies (6), which found threefold more frequent involvement of female patients in their corticosteroid-allergic populations. These wide differences among studies could be related to regional differences in prescription habits.…”

Section: Discussionsupporting

confidence: 66%

“…Currently, all corticosteroid allergy markers included in the Spanish baseline series or TRUE Test® belong to group 1, and might not detect contact allergy to corticosteroids from the other two groups. Notwithstanding this, several studies supporting the use of the above markers showed 80% sensitivity in detecting allergy to other corticosteroids . However, most of these studies are retrospective and limited to single centres.…”

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confidence: 99%

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Are the Spanish baseline series markers sufficient to detect contact allergy to corticosteroids in Spain? A GEIDAC prospective study

et al. 2017

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SummaryBackground. Corticosteroids are among the most commonly used topical drugs. Contact allergy to these exists, but can be easily missed. Corticosteroid screening markers have been included in the baseline series with the aim of detecting most of the sensitized patients. Objectives. To assess the prevalence of contact allergy to topical corticosteroids in Spain and examine the usefulness of corticosteroid markers to detect contact allergy to corticosteroids. Methods. In total, 3699 patients referred to 20 dermatology departments across Spain for patch testing with the baseline series, including budesonide and tixocortol pivalate, were also tested with six supplementary corticosteroids (methylprednisolone aceponate, mometasone furoate, prednicarbate, clobetasol propionate, betamethasone 17-valerate, and betamethasone 17,21-dipropionate). Additionally, 2547 (68.8%) patients were tested with hydrocortisone 17-butyrate. Results. Fifty-four patients showed positive reactions to at least one of all tested corticosteroids (1.46%). Thirty-nine (1.05%) reacted to at least one of the additionally tested corticosteroids; among these, 24 of 39 (61.5%) did not react to any of the corticosteroid allergy screening markers tested. Conclusions. More than half of the patients who were allergic to the additionally tested corticosteroids were not detected with the corticosteroid allergy markers. An update of the corticosteroid allergy screening markers is encouraged, with consideration of group 3 corticosteroids.

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“…The prevalence of contact allergy to topical corticosteroids found in the present study (1.46%) is similar to previously reported values in Spain . Berbegal et al.…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 66%

mentioning

confidence: 99%

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Are the Spanish baseline series markers sufficient to detect contact allergy to corticosteroids in Spain? A GEIDAC prospective study

et al. 2017

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“…Whereas a recent large study from Europe reported that 1.2% of patch tested patients have corticosteroid contact hypersensitivity, cutaneous adverse drug reactions (CADRs) caused by systemic corticosteroids are less well described . Coopman et al originally defined four classes of corticosteroids according to their structure (A, B, C, and D); however, a recent simplified classification system proposed by Baeck and Goossens has refined this further into three different groups (1, 2, and 3) .…”

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confidence: 99%

Cutaneous adverse drug reaction induced by oral dexamethasone with possible cross‐reactivity to Group 1 corticosteroids confirmed by patch testing and intradermal testing

2019

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K E Y W O R D S : case report, corticosteroids, cross-reactivity, cutaneous adverse drug reaction, dexamethasone, intradermal testing, patch testing Whereas a recent large study from Europe reported that 1.2% of patch tested patients have corticosteroid contact hypersensitivity, 1 cutaneous adverse drug reactions (CADRs) caused by systemic corticosteroids are less well described. 2 Coopman et al originally defined four classes of corticosteroids according to their structure (A, B, C, and D) 3 ; however, a recent simplified classification system proposed by Baeck and Goossens has refined this further into three different groups (1, 2, and 3). 4 Cross-reactivity does not always follow this categorization. Here, we report a novel case of a CADR induced by oral dexamethasone with possible cross-reactivity to Group 1 corticosteroids. CASE REPORTAn 80-year-old male underwent dental implant surgery, and was subsequently started on oral dexamethasone, clindamycin, and metronidazole. Forty-eight hours later, he developed a generalized maculopapular exanthema, which resolved over the course of 7 days following medication discontinuation. He reported no previous reactions to corticosteroids. Intradermal testing was later performed with the diluted (0.9% NaCl) stock concentrations of dexamethasone (1:10 of 3.3 mg/mL), clindamycin (1:10 of 150 mg/mL), and metronidazole (1:10 of 5 mg/mL). On delayed reading at 48 hours, there was a strong positive reaction to dexamethasone only, with an exuberant bullous lesion at the test site (Figure 1). We then conducted cross-reactivity studies by the use of patch testing with IQ Ultra chambers and a corticosteroid series (Chemotechnique Diagnostics, Vellinge, Sweden). The patch tests were read on day (D) 2 and D4 in accordance with ICDRG criteria, following 48 hours of occlusion. Patch testing showed strong positive (++) reactions on D4 to tixocortol pivalate (0.1% pet.) and dexamethasone disodium phosphate (1% pet.), and negative responses to the remainder of the corticosteroid series tested (budesonide 0.01% pet., clobetasol propionate 1% pet., betamethasone valerate 1% pet., and hydrocortisone butyrate 1% ethanol) (Figure 2). Further intradermal studies were also conducted with triamcinolone acetonide (1:10 of 40 mg/mL), hydrocortisone sodium succinate (1:10 of 50 mg/mL), and methylprednisolone (1:10 of F I G U R E 1 Intradermal test results at the 48-hour reading for: (A) dexamethasone (positive with bullous lesion); (B) clindamycin (negative); and (C) metronidazole (negative) 384 WATTS ET AL.

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