Patch testing of budesonide in Italy: The SIDAPA baseline series experience, 2018–2019

Abstract

Background Budesonide was included in the European Baseline Series in 2000 as the most suitable marker forcorticosteroid hypersensitivity. In the last two decades, a decreasing trend of budesonide allergy has been observed. Objectives To estimate the prevalence of positive patch test reactions to budesonide in a large, Italian patch test population, characterizing patients according to MOAHLFA index and evaluating the benefit with extended readings of budesonide patch test. Methods Retrospective analysis of patient demographics and patch test results over a 2‐year period (2018–2019) was performed at 14 patch test clinics in Italy. Results Ninety out of 14 544 (0.6%) patients reacted to budesonide 0.01% pet.. Positive reactions were mild in 54.4% and late readings at day 7 showed new positive reactions in 37.8% of patients. The MOAHLFA index showed a significant positive association with male gender, atopic dermatitis, and age >40 years and a significant negative association with hand and face dermatitis. Conclusions We documented a low prevalence of budesonide allergy in Italy, confirming its decreasing trend recently reported in the literature. Nevertheless, budesonide needs to be maintained in the baseline series for its good ability to detect corticosteroid sensitization.

Prevalence of contact allergy to corticosteroids in a Danish patient population

“…A Belgium study reported an overall budesonide sensitization of 1.9% between 1990 and 2014 23 . Recently, European multicentre studies reported decreased prevalence of 0.6%–0.7%, 3,4,18 while the prevalence in our study was stable from 2006 to 2020.…”

“…23 However, most recently, Murphy et al 28 4 Age above 40 years was an only individual risk factor for development of corticosteroid sensitization, as previously reported. 3,18 The time lived intuitively increase risk of corticosteroid skin contact, risk of chronic dermatosis and thereby cumulative dose of topical corticosteroids. The risk of inducing contact sensitization to corticosteroids is increased by cumulative exposure, simultaneous occlusion, potency of the allergen and the nature of the skin treated.…”

“…16,17 From a dermatological perspective, increasing amount of corticosteroids applied to the skin increases the risk for delayed hypersensitivity, as the route of contact sensitization to topical corticosteroids is primarily cutaneous. 18 Therefore, chronic dermatoses such as atopic dermatitis (AD) and stasis dermatitis of the lower extremities are specifically associated with development of ACD to corticosteroids. 6,19 In 2011, Vind-Kezunovic et al 19 method, 20 were retrieved from the Allergen database, Odense University Hospital (journal no.…”

A retrospective study of standard series patch test data from a tertiary referral centre in Singapore from 2014 to 2019

“…This study also underscores the importance of a late reading, as 17.0% of positive patch test results only manifested on day 7. This was especially the case for neomycin (56.5%), budesonide (44.4%), and flavine (42.9%), which is consistent with our previous study and the existing literature 2,9 …”

The efficacy of Janus kinase inhibitors in patients with atopic dermatitis: A systematic review and network meta‐analysis

“…Topical corticosteroids (TCS) are used as first‐line therapy in the management of patients with AD for both acute flares and maintenance, showing promising efficacy for AD patients 31,32 . However, due to its adverse events (AEs) such as skin atrophy, striae, and allergic contact dermatitis, as well as unsatisfied efficacy in the moderate and severe forms, TCS is limited for its usage in AD patients 32–34 . With the development of topical (such as tacrolimus and sirolimus) and systematic therapy (such as dupilumab, nemolizumab, and lebrikizumab) for AD, new drugs had significantly improved the symptom of pruritus and skin lesions of AD patients, with a satisfying safety profile.…”