pulmicort and Dermatitis--Occupational

Budesonide was included in the European Baseline Series in 2000 as the most suitable marker forcorticosteroid hypersensitivity. In the last two decades, a decreasing trend of budesonide allergy has been observed.. To estimate the prevalence of positive patch test reactions to budesonide in a large, Italian patch test population, characterizing patients according to MOAHLFA index and evaluating the benefit with extended readings of budesonide patch test.. Retrospective analysis of patient demographics and patch test results over a 2-year period (2018-2019) was performed at 14 patch test clinics in Italy.. Ninety out of 14 544 (0.6%) patients reacted to budesonide 0.01% pet.. Positive reactions were mild in 54.4% and late readings at day 7 showed new positive reactions in 37.8% of patients. The MOAHLFA index showed a significant positive association with male gender, atopic dermatitis, and age >40 years and a significant negative association with hand and face dermatitis.. We documented a low prevalence of budesonide allergy in Italy, confirming its decreasing trend recently reported in the literature. Nevertheless, budesonide needs to be maintained in the baseline series for its good ability to detect corticosteroid sensitization.

Topics: Adult; Age Distribution; Aged; Budesonide; Cross Reactions; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Occupational; Female; Humans; Italy; Male; Middle Aged; Patch Tests; Prevalence; Retrospective Studies; Sex Distribution

Corticosteroids can cause hypersensitivity reactions, particularly delayed-type allergic reactions. A new classification system for testing hypersensitivity to corticosteroids distributes the drugs into 3 groups according to molecular structure; patients are classified according to whether they are allergic to agents in 1 or more of the groups. We aimed to describe the clinical characteristics of corticosteroid-allergic patients treated at our clinic and apply the new classification system to them; we also compared these patients' characteristics to those of others treated at our clinic.. Retrospective study of cases of delayed-type corticosteroid hypersensitivity treated in the skin allergy clinic of a tertiary level hospital over an 11-year period.. We reviewed the records of 2857 patients, finding 33 with at least one positive patch test result showing corticosteroid hypersensitivity. Atopic dermatitis and hand involvement were less common in our corticosteroid-allergic patients. All were allergic to a group 1 corticosteroid (most often, budesonide, the culprit in 87.9%). Testing with a specific corticosteroid series revealed that 14 (42.4%) were also allergic to corticosteroids in group 2 and/or group 3. None were allergic exclusively to group 2 or group 3 agents. Twenty-one patients were exposed to a corticosteroid cream from a group their patch test results indicated allergy to; 13 of them (61.9%) did not develop a hypersensitivity reaction.. The Spanish standard series only contains group 1 corticosteroids. In the interest of improving allergy management, we recommend testing with a specific corticosteroid series and a patient's own creams whenever patch testing with a standard series reveals a hypersensitivity reaction to corticosteroids.

Topics: Adrenal Cortex Hormones; Adult; Aged; Allergy and Immunology; Budesonide; Dermatitis, Allergic Contact; Dermatitis, Occupational; Drug Hypersensitivity; Female; Hand Dermatoses; Humans; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Male; Middle Aged; Molecular Structure; Outpatient Clinics, Hospital; Patch Tests; Retrospective Studies; Spain; Tertiary Care Centers

Corticosteroids are used to treat dermatoses, including allergic contact dermatitis, but can also cause contact allergy. The frequency of corticosteroid allergy varies between studies and is influenced by treatment traditions and availability.. To estimate the prevalence of tixocortol-21-pivalate, budesonide and hydrocortisone-17-butyrate allergy in a Danish patch test population and characterize individuals with corticosteroid allergy.. Three thousand five hundred and ninety-four patients were patch tested with tixocortol-21-pivalate, budesonide, and hydrocortisone-17-butyrate. Characterization was performed according to the MOAHLFA index and duration of disease.. Two per cent had a steroid allergy: 0.8% had a tixocortol-21-pivalate allergy, 1% a budesonide allergy, and 1% a hydrocortisone-17-butyrate allergy. Tixocortol-21-pivalate and budesonide allergy were associated with atopic dermatitis in crude analyses, but only tixocortol-21-pivalate allergy and atopic dermatitis remained associated in adjusted analyses. Leg dermatitis was uniquely associated with tixocortol-21-pivalate allergy. Hydrocortisone-17-butyrate allergy was associated with duration of disease in both crude and adjusted analyses.. Chronic dermatoses (atopic dermatitis and leg dermatitis) were identified as risk factors for group A corticosteroid allergy, probably because of more pronounced exposure to group A steroids resulting from ease of access that is exploited by patients with a chronic dermatosis. The duration of disease rather than the dermatosis itself seemed to be important for group B and D2 corticosteroid allergy.

Topics: Adult; Budesonide; Chronic Disease; Denmark; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Occupational; Dermatologic Agents; Facial Dermatoses; Female; Hand Dermatoses; Humans; Hydrocortisone; Leg Dermatoses; Male; Middle Aged; Patch Tests; Prevalence; Risk Factors

Inhalation corticosteroids (CSs), despite their wide use, rarely cause sensitization in subjects administering them.. To determine the cause of sensitization and/or of allergic contact dermatitis which occurred in air-exposed body areas of patients reacting to corticosteroids and to budesonide, in particular.. We reviewed the patch test results and sensitization sources in patients who reacted positively to corticosteroids tested in the K.U. Leuven Dermatology department during an 18-year period.. Fifteen subjects, not themselves treated by budesonide-containing aerosols, but taking care of/or living together with patients who used them because of a chronic respiratory affection, appeared to have been sensitized by airborne exposure and/or presented with airborne allergic contact dermatitis from them.. Air exposure to inhalation corticosteroids used 'by proxy' and to budesonide, in particular, needs to be taken into account as a potential cause of primary sensitization and/or airborne allergic contact dermatitis, sometimes also in an occupational context.

Topics: Adult; Aerosols; Anti-Inflammatory Agents; Budesonide; Dermatitis, Allergic Contact; Dermatitis, Occupational; Drug Eruptions; Family Health; Female; Humans; Male; Middle Aged; Retrospective Studies

Topics: Administration, Inhalation; Adult; Budesonide; Dermatitis, Allergic Contact; Dermatitis, Occupational; Female; Humans; Particulate Matter; Patch Tests; Risk Factors; Sensitivity and Specificity

Topics: Administration, Inhalation; Air Pollutants, Occupational; Bronchodilator Agents; Budesonide; Dermatitis, Occupational; Female; Humans; Middle Aged; Nursing Staff, Hospital

The reported prevalence of allergic contact dermatitis from topical corticosteroids in clinical populations, in the period 1993-2002, varied from 0.55 to 5.98%. This study is a retrospective analysis of 1153 individuals undergoing routine patch testing in an Occupational Dermatology Clinic in Melbourne, Australia. We report a rate of 0.52% for positive patch test reactions to 5 corticosteroids. Corticosteroids tested were betamethasone-17-valerate, budesonide, Diprosone cream (betamethasone diproprionate 0.05%) (Essex-Pharma, a division of Schering-Plough Pty Ltd, Sydney, Australia), tixocortol-21-pivalate and triamcinolone acetonide. Population characteristics were described using the MOAHL (M = percentage of males tested; O = occupational; A = atopics; H = patients with hand eczema; L = patients with leg ulcers or stasis eczema) index. Prescribing patterns, rate of referral and rate of relevant positive patch test reactions were characterized for the region. These results were compared to the rates of corticosteroid allergy and patch testing methodologies from published international studies. It was noted that many high-sensitization potential corticosteroids were not available in our region. Although a low percentage of leg ulcers and stasis dermatitis may be associated with a lower rate of corticosteroid allergy, this association may be confounded by regional factors such as prescribing habits and the local availability of corticosteroids. We conclude that the low rate of topical corticosteroid contact allergy reported by our clinic is associated with regional availability and prescribing practices and the scarcity of stasis dermatitis and leg ulcers in our clinic population.

Topics: Administration, Topical; Adult; Australia; Betamethasone; Betamethasone Valerate; Budesonide; Dermatitis, Allergic Contact; Dermatitis, Occupational; Drug Utilization; Female; Glucocorticoids; Humans; Hydrocortisone; Male; Middle Aged; Patch Tests; Practice Patterns, Physicians'; Prevalence; Retrospective Studies; Triamcinolone Acetonide

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Budesonide; Coloring Agents; Dermatitis, Occupational; Diagnosis, Differential; Foot Dermatoses; Glucocorticoids; Hand Dermatoses; Humans; Male; Occupational Exposure; Patch Tests; Phenylenediamines