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Related Experiment Videos

Patch testing to detect corticosteroid allergy: is it adequate?

D C Seukeran1, S M Wilkinson, M H Beck

  • 1Department of Dermatology, General Infirmary at Leeds, UK.

Contact Dermatitis
|March 1, 1997
PubMed
Summary
This summary is machine-generated.

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Ethanol-based corticosteroid patch testing is sensitive but can yield false negatives. Hydrocortisone-17-butyrate patch tests missed 30% of allergies, suggesting caution for patients allergic to tixocortol pivalate and budesonide.

Area of Science:

  • Dermatology
  • Allergology
  • Pharmacology

Background:

  • Patch testing is crucial for diagnosing corticosteroid allergies.
  • Ethanol formulations of corticosteroids show higher sensitivity in patch testing compared to petrolatum or cream bases.
  • The rate of false-negative reactions with ethanol-based patch tests for corticosteroids is not well-established.

Purpose of the Study:

  • To compare the sensitivity of ethanol-based corticosteroid patch testing with intradermal testing.
  • To evaluate the frequency of false-negative reactions in corticosteroid patch testing using ethanol as a vehicle.

Main Methods:

  • Comparison of patch testing with 1% corticosteroid in ethanol against intradermal (i.d.) tests using 1 mg corticosteroid in normal saline.
  • Specific corticosteroids tested included tixocortol pivalate, budesonide, and hydrocortisone-17-butyrate.

Related Experiment Videos

  • Detection of allergic reactions was assessed for each testing method and corticosteroid.

    • Main Results:

    • Patch tests with tixocortol pivalate and budesonide accurately identified all patients allergic to hydrocortisone and budesonide, respectively.
    • Ethanol as a vehicle for other corticosteroids resulted in both false-positive and false-negative patch test reactions.
    • Hydrocortisone-17-butyrate patch tests exhibited a 30% rate of false-negative reactions compared to intradermal testing.

    Conclusions:

    • While ethanol-based patch testing is sensitive for some corticosteroids, false negatives can occur.
    • Hydrocortisone-17-butyrate patch testing may miss a significant proportion of true allergies.
    • Consideration should be given to advising avoidance of hydrocortisone-17-butyrate in patients with positive patch tests to tixocortol pivalate and budesonide.