title: Effect of coadministration of corticosteroids on the development of contact sensitization.
abstract: BACKGROUND
  Transdermal administration of drugs can increase patient compliance and reduce side effects, but it can also cause contact sensitization. Corticosteroids frequently are used to suppress the local immune response; however, their use as a pretreatment for transdermal system application sites is not practical.
  
  
  OBJECTIVE
  Our purpose was to determine the feasibility of suppressing contact sensitization by delivering a corticosteroid with the transdermal delivery systems.
  
  
  METHODS
  Materials were applied continuously for 3 weeks to the same (protocol SS) or different (protocol AS) skin sites. Skin flux and appearance of sensitization were determined.
  
  
  RESULTS
  Coadministration of hydrocortisone reduced the incidence of sensitization by d-chlorpheniramine and benzoyl peroxide from 45% to 7.5% and from 20% to 2.3%, respectively, under protocol SS. Under protocol AS, sensitization by d-chlorpheniramine was reduced from 15% to 1%. Frequent exposure to the sensitizer plus corticosteroid induced tolerance to the sensitizer.
  
  
  CONCLUSIONS
  Sensitization by moderately immunogenic drugs after any length of exposure may be reduced to acceptable levels by the coadministration of hydrocortisone.
authors.affiliation: ALZA Corporation, Palo Alto, CA 94303-0802, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Amkraut
authors.forename: W P
authors.initials: WP
authors.lastname: Jordan
authors.forename: L
authors.initials: L
authors.lastname: Taskovich
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001585:Benzoyl Peroxide / Q000008:administration & dosage / Q000009:adverse effects; D002744:Chlorpheniramine / Q000008:administration & dosage / Q000009:adverse effects; D003877:Dermatitis, Contact / Q000209:etiology / Q000517:prevention & control*; D004338:Drug Combinations; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007108:Immune Tolerance; D007114:Immunization; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000009:adverse effects; D010349:Patient Compliance; D012867:Skin / Q000276:immunology; D012869:Skin Absorption
chemical_list: D018926:Anti-Allergic Agents; D004338:Drug Combinations; D007641:Keratolytic Agents; D002744:Chlorpheniramine; D001585:Benzoyl Peroxide; D006854:Hydrocortisone