[Toxicoderma caused by prednisone and prednisolone. Value of skin tests in the screening of cross sensitivity].
BACKGROUND
Allergic reactions to general corticosteroid therapy are uncommon.


METHODS
We report a patient with systemic lupus erythematousus who developed skin rash after initiation of prednisone then prednisolone therapy. Histology evidence suggested leukocytoclastic vasculitis. The skin tests (prick tests, intradermoreactions and patch-tests) using a battery of injectable corticosteroids showed a highly positive reaction to prednisolone, methylprednisolone and dexamethasone on the intradermo-reactions 24 hours later. Histology examination of a positive-response showed leukocytoclastic vasculitis associated with eczematiform alterations of the epidermis compatible with a drug reaction. The skin tests however were negative for betamethasone, triamcinolone, paramethasone and hydrocorticose. The patient was treated with betamethasone and no skin reaction was observed.


CONCLUSIONS
Skin tests, particularly intradermo-reactions read 24 hours later would appear to be useful in identifying possible cross-sensitivity.
Mathelier-Fusade
P
P
Centre d'Allergie, Hôpital Rothschild, Paris.
Marinho
E
E
Aissaoui
M
M
Mounedji
N
N
Chabane
M H
MH
Leynadier
F
F
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003429:Cross Reactions; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use; D012882:Skin Tests
D000893:Anti-Inflammatory Agents; D011239:Prednisolone; D011241:Prednisone