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Allergy to systemic and intralesional corticosteroids
The British Journal of Dermatology
|April 1, 1993
Summary
Diagnosing corticosteroid allergy involves skin testing and provocation. This study found that while some patients reacted to specific corticosteroids like hydrocortisone and methylprednisolone, others showed no reaction to betamethasone via skin tests.
Area of Science:
- Dermatology
- Allergology
- Clinical Immunology
Background:
- Corticosteroids are widely used for their anti-inflammatory properties.
- Adverse reactions, including allergic responses, can occur with systemic or intralesional corticosteroid use.
- Accurate diagnosis of corticosteroid allergy is crucial for patient management.
Purpose of the Study:
- To characterize allergic reactions to systemic and intralesional corticosteroids.
- To evaluate the utility of skin tests (patch and intradermal) in diagnosing corticosteroid allergy.
- To compare the effectiveness of skin testing versus provocation in identifying corticosteroid sensitivity.
Main Methods:
- Five patients with suspected corticosteroid allergy were included.
- Patients underwent oral or intra-articular corticosteroid challenges (provocation tests).
- Skin tests, including patch testing and intradermal testing, were performed using various corticosteroids.
Main Results:
- Patients exhibited diffuse erythema on the trunk or face within 24 hours of provocation.
- One patient showed positive patch test reactions to prednisolone and methylprednisolone.
- Intradermal tests identified sensitivity to hydrocortisone and methylprednisolone in some patients, while betamethasone allergy was not confirmed by skin tests.
Conclusions:
- A combination of intradermal and patch testing is recommended for suspected corticosteroid allergy.
- Provocation testing remains the method of choice if skin tests are negative.
- Skin testing can help identify specific corticosteroid allergens, guiding safer treatment choices.