Corticosteroids.
Up to 5% of dermatitis patients are allergic to corticosteroids. Because such allergy may be difficult to suspect due to the anti-inflammatory action of the corticosteroid, markers for corticosteroid allergy should be present in any standard series. Budesonide and tixocortol pivalate are two such markers, and they seem to detect a majority of corticosteroid allergy. The patch test concentration for a given corticosteroid may be crucial. A false-negative reaction may follow despite the patient being allergic, if too high a test concentration is used, because of the anti-inflammatory action of the corticosteroid. Patch test readings must be performed not only on Day 3 or Day 4 but also on a late occasion, i.e., Day 7 after test application, also because the anti-inflammatory action may suppress an allergic reaction at an early reading. Once a patient has reacted to a corticosteroid, an extended corticosteroid series should be tested, so that information may be given on which corticosteroids to use and, above all, which corticosteroids to avoid.
Department of Occupational and Environmental Dermatology, Malmö University Hospital, Sweden. marlene.isaksson@skane.se
Marléne
M
Isaksson
D000284:Administration, Oral; D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D010328:Patch Tests; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index
D000305:Adrenal Cortex Hormones