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Corticosteroid allergy

S Freeman1

  • 1Contact & Occupational Dermatitis Clinic, Skin and Cancer Foundation, Sydney, Australia.

Contact Dermatitis
|October 1, 1995
PubMed
Summary
This summary is machine-generated.

Diagnosing corticosteroid allergy is challenging due to unreliable patch tests. Testing with the patient's corticosteroid in a cream base, alongside delayed readings and repeat open application tests, improves diagnostic accuracy for corticosteroid allergy.

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Area of Science:

  • Dermatology
  • Allergology
  • Pharmacology

Background:

  • Corticosteroid allergy is an emerging clinical concern.
  • Accurate diagnosis is hindered by frequent false-negative patch test results.
  • Optimal patch testing concentrations and vehicles for corticosteroids remain undetermined.

Purpose of the Study:

  • To evaluate diagnostic methods for corticosteroid allergy.
  • To determine the most effective patch test concentrations and vehicles.
  • To assess the utility of specific corticosteroids and repeat open application tests in diagnosis.

Main Methods:

  • Analysis of patch test results from 19 patients with suspected corticosteroid allergy.
  • Comparison of patch testing with patient's corticosteroid in cream, ointment, petrolatum, and alcohol bases.

Related Experiment Videos

  • Inclusion of tixocortol pivalate and budesonide for cross-reactivity assessment.
  • Evaluation of delayed readings and repeat open application tests (ROAT).

    • Main Results:

    • Patch testing with the patient's corticosteroid in a commercial cream base yielded more positive results than other preparations.
    • Tixocortol pivalate and budesonide showed some utility in detecting hydrocortisone allergy but not necessarily others.
    • Delayed positive patch tests were frequently observed, highlighting the need for late readings.
    • Repeat open application tests (ROAT) with the patient's own corticosteroid proved to be a simple and useful diagnostic tool.

    Conclusions:

    • Patch testing with corticosteroids in their original cream vehicle is recommended for improved diagnostic yield.
    • Delayed reading of patch tests is crucial for accurate corticosteroid allergy diagnosis.
    • Repeat open application tests offer a valuable and straightforward method for diagnosing corticosteroid allergy.