fluticasone and Dermatitis--Allergic-Contact

We cannot as yet fully answer the question of the safety of the new corticosteroids. Budesonide is frequently found to be an allergen now that it is being marketed, and it can certainly serve as a primary sensitizer. For the other new corticosteroids, too, we already had numerous positive tests even before they were marketed. This must be considered cross-sensitivity. We will have to wait to see whether or not they are primary sensitizers. For the pharmaceutical industry, there is one more challenge in the development of new corticosteroids: In addition to finding more effective corticosteroids with the fewest "classic" side effects, the industry will also have to identify the least sensitizing molecules.

Topics: Administration, Topical; Adrenal Cortex Hormones; Allergens; Androstadienes; Animals; Anti-Inflammatory Agents; Budesonide; Dermatitis, Allergic Contact; Drug Eruptions; Fluticasone; Glucocorticoids; Humans; Mometasone Furoate; Prednisolone; Pregnadienediols; Pregnenediones

In this study we used the nickel contact allergy patch (CAP) test to investigate the effect of topical corticosteroids on allergic contact dermatitis (ACD). On day 1, three CAP tests were applied for 48 h on the forearms of 20 female volunteers with a known nickel ACD. CAP of the right forearm contained 5% nickel, and of the left forearm physiological saline. Clinical scoring, transepidermal water loss and skin hydration were measured on day 1 before CAP application, on day 4 (0, 2 and 6 h) after ACD and from days 5 to 8 (0 h). A topical corticosteroid and its vehicle were applied twice daily starting from day 4 on two ACD sites. Transepidermal water loss values were significantly decreased on the topical-corticosteroid-treated sites in the early phase of ACD (day 4, 6 h after the first application) while clinical efficacy showed significant improvement on days 7 and 8. The vehicle was found to improve skin hydration only on day 8. In conclusion the topical corticosteroid improved the skin barrier function in the early inflammatory phase of ACD (day 4, 6 h). The lack of improvement in transepidermal water loss in the later phase of ACD might be accounted for by the secondary effects of the corticosteroid on proliferation and differentiation of keratinocytes.

Topics: Administration, Cutaneous; Adult; Androstadienes; Anti-Inflammatory Agents; Dermatitis, Allergic Contact; Dermatologic Agents; Double-Blind Method; Female; Fluticasone; Glucocorticoids; Humans; Nickel; Patch Tests; Treatment Outcome; Water Loss, Insensible

Nickel (Ni) allergic contact dermatitis (ACD) alters the skin barrier.. Our aim was to compare the efficacy of combination therapies on ACD, using a topical corticosteroid and a corneotherapy agent (barrier cream), with that of a single therapy with corticosteroids.. On day 1, 3 Ni test patches were applied on each forearm of 14 Ni-patch-test-positive females. Four contained 5% Ni and 2 physiological saline. Either topical corticosteroid or barrier cream were matched with the combination of both products on 3 of the 4 Ni ACD. The fourth was not treated. Clinical scoring, transepidermal water loss (TEWL) and stratum corneum (SC) capacitance were measured before (day 1) and after (days 4-8) ACD.. The combination therapy showed a significant decrease in TEWL values and an increase in SC capacitance.. Combining a topical corticosteroid with corneotherapy agents prevents the delay in the healing process of skin barrier disruption due to ACD.

Topics: Administration, Cutaneous; Adult; Allantoin; Allergens; Androstadienes; Anti-Inflammatory Agents; Dermatitis, Allergic Contact; Double-Blind Method; Drug Combinations; Drug Therapy, Combination; Female; Fluticasone; Forearm; Glucocorticoids; Hexachlorophene; Humans; Nickel; Patch Tests; Squalene; Water Loss, Insensible

Topics: Administration, Inhalation; Administration, Intravenous; Administration, Oral; Adult; Aftercare; Anti-Inflammatory Agents; Benzyl Alcohols; Bronchitis; Bronchoscopy; Chlorobenzenes; Dermatitis, Allergic Contact; Emergency Service, Hospital; Fluticasone; Humans; Hydrocortisone; Inhalation Exposure; Male; Prednisolone; Tear Gases; Tracheitis; Treatment Outcome

Topics: Administration, Topical; Androstadienes; Anti-Inflammatory Agents; Dermatitis, Allergic Contact; Drug Eruptions; Fluticasone; Glucocorticoids; Humans; Mometasone Furoate; Patch Tests; Pregnadienediols; Risk Factors

Topics: Administration, Topical; Adrenal Cortex Hormones; Androstadienes; Anti-Inflammatory Agents; Dermatitis, Allergic Contact; Fluticasone; Glucocorticoids; Humans; Leg Dermatoses; Male; Middle Aged; Ointments