Optimal Testing for Contact Allergy to Topical Corticosteroids

Reitamo, Sakari; Lauerma, Antti; Förström, L

doi:10.1007/978-3-642-74299-6_49

Cited by 9 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

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

“…For many corticosteroids, a l% dilution in ethanol has been suggested as ideal (3)(4)(5). However, for budesonide, the use of petrolatum as vehicle (3,6), and for hydrocortisone the use of tixocortol pivalate in petrolatum (7,8), have been found to produce equivalent results.…”

mentioning

confidence: 99%

Patch testing to detect corticosteroid allergy: is it adequate?

1997

View full text Add to dashboard Cite

Whilst patch testing with corticosteroids in ethanol is more sensitive than either petrolatum or the cream formulation, the frequency of false-negative reactions is not known. We have compared patch testing with corticosteroid at 1% in ethanol with intradermal (i.d.) tests using 1 mg corticosteroid suspended in normal saline. Patch tests with tixocortol pivalate and budesonide detected all patients allergic to hydrocortisone and budesonide, respectively. For other corticosteroids, the use of ethanol as a vehicle resulted in both false-positive and false-negative reactions. In particular, patch tests with hydrocortisone-17-butyrate missed 30% of all positive reactions detected by i.d. testing. There may be a case for advising the avoidance of this steroid in all patients who are positive on patch testing to tixocortol pivalate and budesonide.

show abstract

“…While application to damaged skin where penetration is higher can cause ACD, patch tests applied to normal skin can cause negative results. Use of other vehicles than petrolatum increase penetration and the probability of positive reactions (3, 13, 14, 23, 24, 25, 29, 31).…”

Section: Discussionmentioning

confidence: 99%

“…But contact sensitivity from steroids themselves is becoming increasingly reported in the past decade (1, 2). It should be suspected, especially, if there is no response to steroid therapy or worsening in the pre‐existing lesions (3–37).…”

mentioning

confidence: 99%

Detection of contact hypersensitivity to corticosteroids in allergic contact dermatitis patients who do not respond to topical corticosteroids

Gönül

Gül

2005

Contact Dermatitis

View full text Add to dashboard Cite

The delayed hypersensitivity development against topical corticosteroids which are used in allergic contact dermatitis (ACD) treatment is an important clinical problem. In our study, 41 ACD patients who did not show any response to topical corticosteroid treatment were patch tested with corticosteroid series and the commercial preparations of corticosteroids and their vehicles. In corticosteroid series, there were budesonide, bethametasone-17-valerate, triamcinolone acetonide, tixocortol pivalate, alclomethasone-17-21-dipropionate, clobetasole-17-propionate, dexamethasone-21-phosphate disodium and hydrocortisone-17-butyrate. We detected positive reaction to corticosteroids in 9 of our cases (22%) (5 single and 4 multiple). The sensitivity was mostly produced by tixocortol pivalate (6 patients). This was followed by triamcinolone acetonide (2 patients) budesonide (2 patients), alclomethasone dipropionate (2 patients), dexamethasone 21 phosphate disodium (2 patients) and betamethasone-17-valerate (1 patient). As a result, it should not be forgotten that the corticosteroids used to treat ACD patients may cause ACD themselves. In ACD patients who did not respond to corticosteroid treatment, routinely applying patch test with corticosteroids should be helpful in directing the treatment.

show abstract

Optimal Testing for Contact Allergy to Topical Corticosteroids

Cited by 9 publications

References 4 publications

Contact Hypersensitivity to Corticosteroids in Routine Patch Test Patients

Contact Hypersensitivity to Corticosteroids in Routine Patch Test Patients

Patch testing to detect corticosteroid allergy: is it adequate?

Detection of contact hypersensitivity to corticosteroids in allergic contact dermatitis patients who do not respond to topical corticosteroids

Contact Info

Product

Resources

About