Contact hypersensitivity to tixocortol pivalate.
BACKGROUND
Tixocortol pivalate is an established marker to topical corticosteroid allergy. The prevalence of tixocortol pivalate hypersensitivity is well established in Europe, where exposure to this corticosteroid as a therapeutic agent varies. In the United States, tixocortol pivalate is not commercially available and the prevalence of hypersensitivity to it is unknown.


OBJECTIVE
We investigated the prevalence of tixocortol pivalate hypersensitivity in our patch-tested population. We further characterized these patients by clinical background, other contact allergens, and the reactivity to other corticosteroids.


METHODS
Tixocortol pivalate has been incorporated in our standard 1-52 patch test series since November 1992. We reviewed the histories and patch test results in all patients tested with the standard 1-52 series from November 1992 to December 1996.


RESULTS
Of 1536 patch-tested patients, 45 had hypersensitivity to tixocortol pivalate. Dermatitis involving the face was the most common (14 patients). Of the 45 patients, 40 had another allergen identified on patch testing. Eighteen patients underwent further patch testing to an extended corticosteroid panel, and 14 had sensitivity to another steroid agent.


CONCLUSIONS
The 2.9% prevalence of tixocortol pivalate hypersensitivity in our patch test population is within the range reported in Europe. Patients with tixocortol pivalate hypersensitivity tend to have other contact allergens on patch testing. Predisposing factors to tixocortol pivalate hypersensitivity include facial dermatitis and sensitivity to other contact allergens.
Lutz
M E
ME
Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
el-Azhary
R A
RA
Gibson
L E
LE
Fransway
A F
AF
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000009:adverse effects; D018926:Anti-Allergic Agents / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D019819:Budesonide / Q000009:adverse effects; D003429:Cross Reactions; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D005060:Europe; D005148:Facial Dermatoses / Q000139:chemically induced; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009355:Neomycin / Q000009:adverse effects; D010328:Patch Tests; D015995:Prevalence; D012307:Risk Factors; D014221:Triamcinolone / Q000009:adverse effects
D000305:Adrenal Cortex Hormones; D000485:Allergens; D018926:Anti-Allergic Agents; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; C007975:hydrocortisone-17-butyrate; D014221:Triamcinolone; C021650:hydrocortisone acetate; D019819:Budesonide; C038363:hydrocortisone valerate; C019112:tixocortol pivalate; D009355:Neomycin; D006854:Hydrocortisone