Patch testing with corticosteroid mixes in Europe. A multicentre study of the EECDRG.
This study investigated whether a corticosteroid mix containing tixocortol pivalate, budesonide, and hydrocortisone-17-butyrate could detect contact allergy to corticosteroids. 2 corticosteroid mixes, 1 with a high (mix I) and 1 with a low (mix II) concentration and the 3 individual constituents, each at 2 concentrations, were inserted into the standard series of 16 participating clinics. Tests were read on day (D) 3 or 4. 5432 patients were tested, and 110 (2.0%) had positive reactions to at least 1 of the 8 test preparations. Of the 8 preparations, mix I identified most allergic patients, followed by mix II, budesonide 0.10%, budesonide 0.002%, and tixocortol pivalate, both concentrations (1.0 and 0.10%) tracing the same number. With the mixes, 53.2-59.6% of tixocortol pivalate allergy was missed. 47 patients were allergic to either concentration of tixocortol pivalate, 25% of these only to 1.0% and another 25% only to 0.10%. Testing with mix I and tixocortol pivalate 0.10% picked up 98/110, testing with tixocortol pivalate 1.0% and 0.10% and budesonide 0.10% picked up 105/110. 3379 patients were read on both D3 or D4 as well as on D7. Without a late reading (D7), up to 30% of contact allergy to corticosteroid markers was missed.
Isaksson
M
M
Department of Occupational and Environmental Dermatology, Malmö University Hospital, Sweden.
Andersen
K E
KE
Brandão
F M
FM
Bruynzeel
D P
DP
Bruze
M
M
Camarasa
J G
JG
Diepgen
T
T
Ducombs
G
G
Frosch
P J
PJ
Goossens
A
A
Lahti
A
A
Menné
T
T
Rycroft
R J
RJ
Seidenari
S
S
Shaw
S
S
Tosti
A
A
Wahlberg
J
J
White
I R
IR
Wilkinson
J D
JD
D000287:Administration, Topical; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D019819:Budesonide / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology; D004338:Drug Combinations; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000031:analogs & derivatives; D008297:Male; D010328:Patch Tests
D000893:Anti-Inflammatory Agents; D004338:Drug Combinations; C007975:hydrocortisone-17-butyrate; D019819:Budesonide; C019112:tixocortol pivalate; D006854:Hydrocortisone