pulmicort and Dermatitis

Contact allergy to corticosteroids has recently gained increased attention.. Five cases of contact dermatitis due to budesonide, a nonhalogenated steroid, are described. The Japanese literature was reviewed for reports on this allergy, and the occurrence due to budesonide was compared with that of other dermocorticosteroids.. Budesonide use can cause contact dermatitis.. Although budesonide may be beneficial because of its anti-inflammatory effects, clinicians should be alert to its potential for causing contact dermatitis.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Budesonide; Chronic Disease; Dermatitis; Dermatitis, Allergic Contact; Dermatitis, Seborrheic; Drug Eruptions; Eczema; Erythema; Female; Glucocorticoids; Humans; Japan; Leg Dermatoses; Male; Pregnenediones; Psoriasis

A 37-year-old patient presented with a severe allergic local reaction upon inhalation of budesonide for asthma. Skin tests were positive for budesonide and amcinonide (group B) and elicited a strong local reaction and a disseminated macular exanthema. Corticosteroids from other groups were well tolerated. A 38-year-old male patient had first an allergic contact dermatitis to topically applied prednisolone acetate and then a disseminated eczematous exanthema upon oral intake of prednisone. A delayed-type sensitization to corticosteroids from group A such as hydrocortisone, prednisone and tixocortol pivalate was identified. A detailed diagnosis in patients with allergic reactions to corticosteroids is crucial with regard to their use in emergency therapy.

Topics: Adrenal Cortex Hormones; Adult; Asthma; Budesonide; Dermatitis; Drug Eruptions; Humans; Hypersensitivity, Delayed; Male; Patch Tests; Prednisolone; Skin

The systemic and topical antiinflammatory activities of budesonide (B) were studied in rats and mice and compared with those of commercially available steroids. Betamethasone 17-valerate (BV) was used as the main reference compound, and fluosinolone acetonide (FA), hydrocortisone 17-butyrate (HB) and hydrocortisone 21-acetate (HA) were also used. B given systemically had stronger antiinflammatory effect than BV on carrageenin edema, cotton pellet granuloma, adjuvant arthritis, croton oil edema, PCA reaction, Arthus reaction, contact hypersensitivity and histamine or serotonin skin reaction. The potency of antiinflammatory activity of the 5 compounds in carrageenin edema, croton oil edema and contact hypersensitivity tests was in the order of FA, B, BV, HB and HA. B given locally also produced stronger antiinflammatory effects than BV on carrageenin edema, cotton pellet granuloma, croton oil edema and contact hypersensitivity. The order of potency of the 5 compounds in carrageenin edema, croton oil edema and contact hypersensitivity tests was the same as by systemic application. In general, the ratio of the dose required to cause atrophy of the thymus and adrenals to the dose required to produce the antiinflammatory effect was the greatest with B by both systemic and local application. The results suggest that B has a stronger antiinflammatory activity with fewer systemic side effects than conventional steroid compounds.

Topics: Adrenal Gland Diseases; Animals; Anti-Inflammatory Agents; Budesonide; Dermatitis; Dermatitis, Contact; Drug Evaluation, Preclinical; Lymphatic Diseases; Mice; Mice, Inbred ICR; Pregnenediones; Rats; Rats, Inbred Strains; Thymus Gland

The antiinflammatory effect of topically applied budesonide ointment on carrageenin induced paw edema in rats, croton oil induced ear edema in rats, passive cutaneous anaphylaxis (PCA) in rats and picrylchloride induced contact hypersensitivity in mice was studied and compared with those of commercially available ointments containing betamethasone 17-valerate, hydrocortisone 21-acetate, hydrocortisone 17-butyrate or fluocinonide. The five ointments had almost the same degree of activity against the carrageenin induced paw edema. Budesonide ointment was strongest in inhibiting the croton oil induced ear edema. Budesonide and fluocinonide ointments were stronger than the other 3 ointments in inhibiting PCA and picrylchloride induced hypersensitivity. No clear atrophic effect on the thymus or adrenal was observed with any of the ointments at the doses tested. When the effect of budesonide ointment was compared with that of budesonide cream, there were no differences in activity between the two formulations. The results suggest that budesonide is a useful drug with a superior topical antiinflammatory activity.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Budesonide; Dermatitis; Dermatitis, Contact; Edema; Emulsions; Mice; Mice, Inbred ICR; Ointments; Passive Cutaneous Anaphylaxis; Pregnenediones; Rats; Rats, Inbred Strains