Pedro Mercader-García1, María A Pastor-Nieto2, Ignacio García-Doval3, Ana Giménez-Arnau4, Ricardo González-Pérez5, Virginia Fernández-Redondo6, Ester Serra-Baldrich7, Susana Cordoba-Guijarro8, María E Gatica-Ortega9, Juan F Silvestre-Salvador10. 1. Dermatology Department, Hospital General Universitario Jose Mª Morales Meseguer, 30008, Murcia, Spain. 2. Dermatology Department, Hospital Universitario de Guadalajara, 19002, Guadalajara, Spain. 3. Unidad de Investigación of the Fundación Piel Sana AEDV of the Spanish Academy of Dermatology, 28008, Madrid, Spain. 4. Dermatology Department, Hospital del Mar, 08003, Barcelona, Spain. 5. Dermatology Department, Hospital Universitario de Araba, 01009, Vitoria-Gasteiz, Spain. 6. Dermatology Deparment, Hospital Gil-Casares, 15706, Santiago de Compostela, Spain. 7. Dermatology Deparment, Hospital Sant Pau, 08025, Barcelona, Spain. 8. Dermatology Deparment, Hospital Universitario de Fuenlabrada, 28942, Madrid, Spain. 9. Dermatology Deparment, Complejo Hospitalario Virgen del Valle, 45071, Toledo, Spain. 10. Dermatology Department, Hospital General de Alicante, 03010, Alicante, Spain.
Abstract
BACKGROUND: Corticosteroids are among the most commonly used topical drugs. Contact allergy to these exists, but can be easily missed. Corticosteroid screening markers have been included in the baseline series with the aim of detecting most of the sensitized patients. OBJECTIVES: To assess the prevalence of contact allergy to topical corticosteroids in Spain and examine the usefulness of corticosteroid markers to detect contact allergy to corticosteroids. METHODS: In total, 3699 patients referred to 20 dermatology departments across Spain for patch testing with the baseline series, including budesonide and tixocortol pivalate, were also tested with six supplementary corticosteroids (methylprednisolone aceponate, mometasone furoate, prednicarbate, clobetasol propionate, betamethasone 17-valerate, and betamethasone 17,21-dipropionate). Additionally, 2547 (68.8%) patients were tested with hydrocortisone 17-butyrate. RESULTS: Fifty-four patients showed positive reactions to at least one of all tested corticosteroids (1.46%). Thirty-nine (1.05%) reacted to at least one of the additionally tested corticosteroids; among these, 24 of 39 (61.5%) did not react to any of the corticosteroid allergy screening markers tested. CONCLUSIONS: More than half of the patients who were allergic to the additionally tested corticosteroids were not detected with the corticosteroid allergy markers. An update of the corticosteroid allergy screening markers is encouraged, with consideration of group 3 corticosteroids.
BACKGROUND: Corticosteroids are among the most commonly used topical drugs. Contact allergy to these exists, but can be easily missed. Corticosteroid screening markers have been included in the baseline series with the aim of detecting most of the sensitized patients. OBJECTIVES: To assess the prevalence of contact allergy to topical corticosteroids in Spain and examine the usefulness of corticosteroid markers to detect contact allergy to corticosteroids. METHODS: In total, 3699 patients referred to 20 dermatology departments across Spain for patch testing with the baseline series, including budesonide and tixocortol pivalate, were also tested with six supplementary corticosteroids (methylprednisolone aceponate, mometasone furoate, prednicarbate, clobetasol propionate, betamethasone 17-valerate, and betamethasone 17,21-dipropionate). Additionally, 2547 (68.8%) patients were tested with hydrocortisone 17-butyrate. RESULTS: Fifty-four patients showed positive reactions to at least one of all tested corticosteroids (1.46%). Thirty-nine (1.05%) reacted to at least one of the additionally tested corticosteroids; among these, 24 of 39 (61.5%) did not react to any of the corticosteroid allergy screening markers tested. CONCLUSIONS: More than half of the patients who were allergic to the additionally tested corticosteroids were not detected with the corticosteroid allergy markers. An update of the corticosteroid allergy screening markers is encouraged, with consideration of group 3 corticosteroids.
Authors: Wolfgang Uter; Thomas Werfel; Jean-Pierre Lepoittevin; Ian R White Journal: Int J Environ Res Public Health Date: 2020-04-01 Impact factor: 3.390