pulmicort and Hand-Dermatoses

Allergic contact dermatitis is the most common adverse reaction caused by topical drugs.. To study the demographic characteristics and lesion locations of patients with iatrogenic dermatitis, and to analyse contact allergy to active principles and trends in frequencies over the years.. Between 1990 and 2014, 14 911 patients were patch tested with the European baseline series. Patients with a presumed iatrogenic cause were often tested with a pharmaceutical series, and, if indicated, with photo-patch tests. Most were also tested with the topical products to which they had been exposed, along with their ingredients.. Eight thousand three hundred and seventy-four (56%) patients tested positively, and 2600 (17.4%, 95%CI: 16.8-18.0%) of all patients suffered from iatrogenic contact dermatitis. The most important primary sites of dermatitis were the legs, face, and hands. The most common sensitizers included topical antibiotics, antiseptics, and corticosteroids. The most frequent baseline allergens in this subgroup were budesonide, neomycin, and benzocaine, although with a decreasing trend over the years. Many other allergens from different pharmacological classes were identified.. With a prevalence of 17.4% of consecutive patients, iatrogenic contact dermatitis is a frequent diagnosis in patients attending a general patch test clinic, involving one-third of the patients with at least one positive reaction.

Topics: Administration, Cutaneous; Administration, Topical; Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Anesthetics, Local; Anti-Bacterial Agents; Anti-Infective Agents, Local; Belgium; Benzocaine; Budesonide; Child; Child, Preschool; Dermatitis, Allergic Contact; Dermatitis, Irritant; Facial Dermatoses; Female; Glucocorticoids; Hand Dermatoses; Humans; Iatrogenic Disease; Infant; Infant, Newborn; Leg Dermatoses; Male; Middle Aged; Neomycin; Patch Tests; Prevalence; Retrospective Studies; Young Adult

Topics: Adult; Budesonide; Chronic Disease; Cross Reactions; Dermatitis, Allergic Contact; Female; Glucocorticoids; Hand Dermatoses; Humans; Hydrocortisone; Patch Tests; Prednisolone

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

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Budesonide; Dermatitis, Allergic Contact; Female; Glucocorticoids; Hand Dermatoses; Humans; Methylprednisolone; Patch Tests

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

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Budesonide; Cross Reactions; Dermatitis, Exfoliative; Drug Eruptions; Glucocorticoids; Hand Dermatoses; Humans; Injections, Intradermal; Male; Pregnenediones