The benefit of late patch test readings in corticosteroid allergy

Svendsen, Sebastian Vigand; Mørtz, Charlotte G.

doi:10.1111/cod.14197

Cited by 6 publications

(5 citation statements)

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“…The group 3 CSs clobetasol‐17‐propionate (in Dermovate) and betamethasone‐17‐valerate (in Betnovate) are frequently used in the treatment of various inflammatory dermatoses such as eczema and cutaneous psoriasis in Denmark. In total, only nine patients sensitised to Group 3 CSs are missed in 1852 patch‐tested patients, and clobetasol‐17‐propionate being a potential Group 3 CS marker, 7,9,20 inclusion of clobetasol‐17‐propionate in consecutively screening panel might optimise the overall sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…Assessment of the clinical relevance of sensitization is based on different clinicians. The intrinsic dual effect of anti‐inflammatory potential and allergenic, inflammatory potential entails challenging patch test readings often being in a spectrum of doubtful to weak positive, thus the experiences of clinicians are important and a delayed patch test reading must happen 20 …”

Section: Discussionmentioning

confidence: 99%

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Contact allergy to corticosteroids: Is the European baseline series sufficient?

2023

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BackgroundPatients are consecutively screened for contact allergy to corticosteroids with budesonide and tixocortol‐21‐pivalate in the European baseline series. Centres using TRUE Test also include hydrocortisone‐17‐butyrate. A supplementary corticosteroid patch test series is used in case of suspicion of corticosteroid contact allergy or when a marker of corticosteroid contact allergy is positive.ObjectiveThe aims were to evaluate (1) the efficacy of corticosteroids in the TRUE Test and (2) co‐sensitization patterns.MethodsThis retrospective study analysed patients patch tested with TRUE Test corticosteroids plus supplementary corticosteroid series in the period 2006–2020 at the Department of Dermatology and Allergy Centre, Odense University Hospital.ResultsOf 1852 patients tested, 119 were sensitised to TRUE Test corticosteroids and supplementary testing found additional reactions to other corticosteroids in 19 of 119 patients. TRUE Test corticosteroids gave more positive and stronger reactions compared to allergens in petrolatum/ethanol. Fourteen percent of sensitised patients were co‐sensitised to multiple corticosteroid groups. Baeck group 3 corticosteroids accounted for 9 of 16 patients not identified by TRUE Test.ConclusionsBudesonide, hydrocortisone‐17‐butyrate, and tixocortol‐21‐pivalate in combination are sensitive corticosteroid markers. In case of clinical suspicion of corticosteroid contact allergy, patch testing with supplementary corticosteroids is highly recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Contact allergy to corticosteroids: Is the European baseline series sufficient?

2023

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“…Due to this tendency in patch test referral pattern, our results may not reflect the general population of patients with AD. Third, as steroid allergens cause late patch test effects due to their anti-inflammatory effects, additional readings are recommended not only on days 2 and 4 after the patch test, but also on day 7 37 . Indeed, Isaksson et al 38 reported that about 28.6% of cases of budesonide sensitization would be missed without readings on day 7.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Positive Patch Test Allergens in Allergic Contact Dermatitis Patients with Atopic Dermatitis

et al. 2023

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Background There has been debate regarding whether patients with atopic dermatitis (AD) have an altered frequency of contact allergen sensitization. Increased exposure to topical medications and moisturizers as well as impaired skin barrier function increase the risk of contact sensitization, whereas the Th2-skewed inflammatory pathway of AD is associated with a reduced risk. Objective This retrospective study was performed to determine the characteristics of contact sensitization in allergic contact dermatitis (ACD) patients with a current or past history of AD. Methods A clinical record review was conducted for patients referred to Ewha Womans University Medical Center, for patch tests between March 2017 and March 2021. We compared the rates of contact sensitization between ACD patients with and without AD. Results In total, 515 patch test results were reviewed and divided into the AD group (n=53) and non-AD group (n=462). The AD group showed decreased any-allergen positivity (1+, 2+, or 3+) (56.6%) compared to the non-AD group (72.9%) ( p =0.013). The positivity rate for budesonide was significantly higher in the AD group ( p =0.011), while the prevalence of a positive result for balsam of Peru was higher in the non-AD group ( p =0.036). Nickel sulfate, cobalt chloride, and potassium dichromate were the most common sensitized allergens in both groups. Conclusion Our study shows a decreased prevalence of contact sensitization in AD patients compared to non-AD patients. Clinicians should be aware of the risk of corticosteroid allergies in ACD patients with history of AD.

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“…antiinflammatoriske effekter, hvorfor senaflaesning af kortikosteroider er saerdeles vigtig [15], men desvaerre spares vaek flere steder i verden.…”

Section: Ugeskrift For Laeger Ugeskrift For Laegerunclassified

Contact allergy to topical corticosteroids

Svendsen,

Mose,

Johansen

et al. 2024

Ugeskr Læger

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Topical corticosteroids are commonly used to treat inflammatory skin conditions due to their anti-inflammatory properties. However, patients with long-lasting, non-responsive eczema have to be evaluated for a complicating contact allergy to the topical product. Clinical management of allergic contact dermatitis to corticosteroids can be challenging. The preventive measures should be tailored according to the sensitization patterns and supported by currently available classification systems to avoid cross-reactivity, as argued in this review.

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The benefit of late patch test readings in corticosteroid allergy

Cited by 6 publications

References 12 publications

Contact allergy to corticosteroids: Is the European baseline series sufficient?

Contact allergy to corticosteroids: Is the European baseline series sufficient?

Analysis of Positive Patch Test Allergens in Allergic Contact Dermatitis Patients with Atopic Dermatitis

Contact allergy to topical corticosteroids

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