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.
Isaksson
Marléne
M
Department of Occupational and Environmental Dermatology, Malmö University Hospital, Sweden. marlene.isaksson@skane.se
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