Results of routine patch testing with corticosteroid series in 2073 patients

Dooms‐Goossens, A.; Morren, Marie‐Anne

doi:10.1111/j.1600-0536.1992.tb00290.x

Cited by 156 publications

(90 citation statements)

References 7 publications

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“…Dermatitli hastalarda tedavi ile düzelme sağlanamadığında veya lezyonlarda artış olduğunda topikal steroidlere bağlı kontakt duyarlılık olasılığı gözden geçirilmelidir 60,61 . Topikal kortikosteroidlere bağlı AKD insidansı %0,2 ile %5 arasında değişmektedir [61][62][63][64][65] . Yapılan çalışmalar sonucunda tiksokortol pivalat ve budesonidin topikal kortikosteroid allerjisi için iyi birer belirleyici oldukları anlaşılmış 66 ve bu gelişmeler sonucunda bu iki kortikosteroid molekülü standart yama testi serisine eklenmiştir.…”

Section: Discussionunclassified

Evaluation of contact sensitivity to topical drugs in patients with contact dermatitis

Şen¹,

Akyol²,

Boyvat³

2013

TURKDERM

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ÖzetAmaç: Topikal ilaçlar kontakt allerjenler arasında önemli bir gruptur. Çalışmamızda, kontakt dermatitli olgularda topikal ilaçlara bağlı kontakt duyarlılığın değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: 2003 ve 2008 yılları arasında Ankara Üniversitesi Tıp Fakültesi Dermatoloji Anabilim Dalı'nda topikal ilaç kullanımına bağlı kontakt dermatit geliştiğinden şüphelenilen 129 hasta çalışmaya alındı. Çalışmada Avrupa standart yama testi serisi ve Medikament yama testi serisi ve hastaların kullanmış olduğu topikal ilaçlarla yapılan test sonuçları değerlendirmeye alındı. Test sonuçlarının klinik tablo ile uyumluluğu değerlendirildi. Bulgular: Çalışmaya alınan 129 hastanın 80'inde (%62,0) bir veya birden fazla allerjene karşı pozitiflik saptandı. Pozitiflik saptanan 80 hastanın 61'inde (61/129, %47,3) medikament pozitifliği olduğu görüldü. Klinik olarak anlamlı medikament duyarlılık sıklığı %37,9 (49/129) olarak saptandı. Nitrofurazon (%18,6) en sık allerjen olarak saptandı. Sonuç: Çalışmamızda topikal olarak uygulanan ilaçlara karşı allerjik kontakt dermatit gelişiminin sık görüldüğü saptanmıştır. Bu nedenle kontakt dermatit şüphesi ile değerlendirilen hastalarda topikal ilaçlara bağlı kontakt duyarlılık ihtimali akılda tutulmalı ve gerekli durumlarda sorumlu antijenin saptanması amacıyla yama testleri ile ileri araştırmalar yapılmalıdır. (Türkderm 2013; 47: 19-25) Anah tar Ke li me ler: Allerjik kontakt dermatit, medikament duyarlılığı, nitrofurazon, topikal ilaçlar, yama testi Sum maryBackground and Design: Topical drugs are an important group of contact allergens. The present study aimed to evaluate contact sensitivity to topical drugs in patients with contact dermatitis. Materials and Methods: Between 2003 and 2008, 129 patients were followed up at the Department of Dermatology at Ankara University School of Medicine with clinically suspected contact sensitivity to topical drugs. In this study, the patch test reactions to the European Standard Battery and topical drugs used by the patients and medicament patch test results were evaluated. Results: Positive patch test reaction to one or more allergens was found in 80 (62.0%) of 129 patients included in the study. Sixty-one of the 80 patients (61/129, 47.3%) had positive patch test reaction to medicaments. Medicament sensitivity was detected in 37.9% (49/129) of subjects. Nitrofurazone was found to be the most common allergen (18.6%). Discussion: The present study showed that topical drugs are a frequent cause of allergic contact dermatitis. Therefore, the probability of contact sensitivity to topical drugs should also be considered in patients with the clinical diagnosis of allergic contact dermatitis and, suspected cases should be evaluated further with patch testing in order to find the responsible allergens. (Turkderm 2013; 47: 19-25)

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Section: Discussionunclassified

Evaluation of contact sensitivity to topical drugs in patients with contact dermatitis

Şen¹,

Akyol²,

Boyvat³

2013

TURKDERM

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“…Classifying adverse reactions to glucocorticoids, delayed type allergic reactions (contact dermatitis) after topical application have to be distinguished from immediate type reactions after systemic administration. Whereas contact dermatitis induced by topically applied glucocorticoids is frequently observed, 7 immediate type hypersensitivity is very rare.…”

Section: Discussionmentioning

confidence: 99%

“…6 Cross-reactivity has been observed between different systemic glucocorticoids, but the recent classification of cross-reactivity between topical glucocorticoids does not seem to apply for immediate adverse reactions to systemic glucocorticoids. 5,7 Therefore, in patients with confirmed immediate type allergy to one or several glucocorticoids, it is insufficient to base counseling simply on chemical structure relationship. The best way to identify glucocorticoids that are a safe option for future therapy is by careful challenge testing.…”

Section: Discussionmentioning

confidence: 99%

Anaphylaxis Induced by Glucocorticoids

Erdmann¹,

Abuzahra²,

Schroeder³

et al. 2005

The Journal of the American Board of Family Medicine

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Glucocorticoids are frequently used to treat allergic reactions. Therefore, allergic reactions to systemic glucocorticoids in particular are considered most unlikely and are not well known. We report on a 23-year-old woman with atopic dermatitis who had an anaphylactic reaction after oral administration of prednisolone. On treatment with epinephrine, antihistamines and volume symptoms resolved. Skin testing with a panel of glucocorticoids showed immediate type reactions to prednisolone, prednisolone hydrogen succinate, prednisone, and betamethasone dihydrogen phosphate. In challenge testing the patient tolerated methyl prednisolone and dexamethasone. There is increasing evidence that true allergic immediate type reactions to glucocorticoids exist. The severity of the reaction can vary from a rash to anaphylaxis. However, a patient sensitized to one or a group of glucocorticoids does not have to refrain from all types of glucocorticoids. Careful challenge testing is by far the best way to select glucocorticoids that are safe for future treatment. Clinicians should be aware that allergic reactions to glucocorticoids can occur and that worsening of symptoms does not always mean treatment failure. (J Am Board Fam Pract 2005;18:143-6.)Since the early 1950s, glucocorticoids have been used extensively for pharmacotherapy. Glucocorticoids are applied topically, orally, or intravenously and, if administered in higher doses, show immunosuppressive, antiproliferative, anti-inflammatory, and antiallergic effects.1 The antiallergic properties of glucocorticoids would seem to contradict their capacity to induce allergic reactions. However, a few severe adverse reactions, including life-threatening reactions caused by systemic glucocorticoids, have been reported over the past decades.2-6 Because the risk of anaphylactic reactions caused by glucocorticoids is not taken into consideration by most clinicians, severe complications may occur, particularly in the treatment of status asthmaticus or in anaphylactic reactions attributable to high doses (ie, if increasing symptoms are thought to be caused by insufficient therapy, even higher doses of glucocorticoids may be applied).We report a patient with an immediate and delayed type hypersensitivity to several glucocorticoids, the diagnostic work-up, including challenge testing, and the options for future treatment with glucocorticoids in patients with glucocorticoid allergy. Case ReportA 23-year-old woman was prescribed prednisolone (Decortin H) because of worsening of atopic dermatitis. Thirty minutes after taking the first oral dose of 40 mg of prednisolone, she developed palmoplantar paraesthesia, tightness of the chest, dizziness, and nausea, and she finally collapsed. In the emergency department, she was treated with epinephrine, antihistamines, and fluid; however, no glucocorticoid was applied because of the clinical history. Within a few hours all symptoms resolved. Two years before at the dentist's office, the patient had shown the same symptoms, albeit less severe, 15 minut...

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“…Petrolatum had previously been demonstrated to be a good vehicle for budenoside. (19) so it appears that this compound allergy was diagnosed on solid patch testing data.…”

Section: Compound Allergy and Patch Testingmentioning

confidence: 97%

Compound allergy

Bashir

Maibach

1997

Contact Dermatitis

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This review defines the term "compound allergy" in the context of new findings, and discusses evidence that allergenic reaction products have been identified. Material was gathered by searching Index Medicus and the Science Citation Index, and reviewing several standard texts. Issues regarding the validity of patch test results are addressed and we introduce the term "pseudocompound allergy" to cover cases of false-negative patch tests. We present new theories regarding the mechanisms by which new allergens are formed and a means of classification.

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Results of routine patch testing with corticosteroid series in 2073 patients

Cited by 156 publications

References 7 publications

Evaluation of contact sensitivity to topical drugs in patients with contact dermatitis

Evaluation of contact sensitivity to topical drugs in patients with contact dermatitis

Anaphylaxis Induced by Glucocorticoids

Compound allergy

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