BACKGROUND: Allergy to topical corticosteroids is more common than previously realized. To detect this allergy, a corticosteroid series is used for patch testing in addition to corticosteroid screens on a standard series. OBJECTIVE: We sought to review our experience with patch testing to corticosteroid series. METHODS: We conducted a retrospective study of patch testing to our corticosteroid series over 6 years (January 1, 2000-December 31, 2005). RESULTS: Of 1188 patients patch tested to corticosteroid series, 127 (10.69%) had allergic reaction to at least one corticosteroid; 56 reacted to multiple corticosteroids. Rates of allergic patch test reaction to 19,611 individual corticosteroids were 0.41% to 5.03%. Rates of reaction to corticosteroid groups were 1.10% to 5.72%; concomitant reactions between groups were noted. Present screens on our standard series identified 74% of those detected on the corticosteroid series; tixocortol pivalate alone detected less than 50%. LIMITATIONS: Limitations include that this study was retrospective and the possible interobserver variation in interpretation of patch tests. CONCLUSION: In patients suggested to have corticosteroid allergy, patch testing confirms allergy in 10.69%; allergy is often to multiple corticosteroids and across groups. Screens on a standard series may detect 74% of those detected on a corticosteroid series.
BACKGROUND:Allergy to topical corticosteroids is more common than previously realized. To detect this allergy, a corticosteroid series is used for patch testing in addition to corticosteroid screens on a standard series. OBJECTIVE: We sought to review our experience with patch testing to corticosteroid series. METHODS: We conducted a retrospective study of patch testing to our corticosteroid series over 6 years (January 1, 2000-December 31, 2005). RESULTS: Of 1188 patients patch tested to corticosteroid series, 127 (10.69%) had allergic reaction to at least one corticosteroid; 56 reacted to multiple corticosteroids. Rates of allergic patch test reaction to 19,611 individual corticosteroids were 0.41% to 5.03%. Rates of reaction to corticosteroid groups were 1.10% to 5.72%; concomitant reactions between groups were noted. Present screens on our standard series identified 74% of those detected on the corticosteroid series; tixocortol pivalate alone detected less than 50%. LIMITATIONS: Limitations include that this study was retrospective and the possible interobserver variation in interpretation of patch tests. CONCLUSION: In patients suggested to have corticosteroid allergy, patch testing confirms allergy in 10.69%; allergy is often to multiple corticosteroids and across groups. Screens on a standard series may detect 74% of those detected on a corticosteroid series.
Authors: Joyce Y Chen; James A Yiannias; Matthew R Hall; Molly J Youssef; Lisa A Drage; Mark D P Davis; Yul W Yang Journal: JAMA Dermatol Date: 2022-09-28 Impact factor: 11.816