Pattern of corticosteroid allergy in Thailand.
BACKGROUND
Corticosteroid allergy is a complication of topical therapy detected by patch-testing with corticosteroid allergens.


OBJECTIVE
Ten-year retrospective review to study the prevalence and patterns of corticosteroid allergy in Thai patients.


RESULTS
Of 882 patients who were patch-tested, 29 (3.29%) had allergic reactions to corticosteroids. Of these 29 patients, 17 (58.62%) had positive reactions to one corticosteroid, and 12 (41.38%) reacted to multiple corticosteroids. Rates of reaction to corticosteroid groups ranged from 31.03 to 80.95%. Concomitant reactions between groups were noted. The prevalence of topical corticosteroid allergy (using two screening allergens, tixocortol pivalate and budesonide) was 2.27% (20 of 882). Testing with additional steroid allergens in suspected cases increased the prevalence to 3.29%. Tixocortol pivalate detected 51.72% of corticosteroid-allergic cases, and budesonide detected 24.14%. Combining both tixocortol and budesonide detected 68.97% of cases.


CONCLUSIONS
Corticosteroid allergy is found to multiple corticosteroids, and concomitant reactions occur across groups. Group D1 corticosteroid esters produced a higher positive reaction rate (61.9%) than groups D2 (52.38%) and A (51.72%). This may be due to different prescribing habits or the easy access to D1 corticosteroids sold over the counter by pharmacies in Thailand.
Wattanakrai
Penpun
P
Section of Contact Dermatitis, Division of Dermatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400. rapwn@mahidol.ac.th
Temnithikul
Bhakinai
B
Pootongkam
Suwimon
S
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects* / Q000145:classification*; D000328:Adult; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000145:classification; D008875:Middle Aged; D010328:Patch Tests; D015995:Prevalence; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D019819:Budesonide; C019112:tixocortol pivalate; D006854:Hydrocortisone