Davis Mark D P, el-Azhary Rokea A, Farmer Sara A
Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Am Acad Dermatol. 2007 Jun;56(6):921-7. doi: 10.1016/j.jaad.2006.11.012. Epub 2007 Jan 19.
Allergy to topical corticosteroids is more common than previously realized. To detect this allergy, a corticosteroid series is used for patch testing in addition to corticosteroid screens on a standard series.
We sought to review our experience with patch testing to corticosteroid series.
We conducted a retrospective study of patch testing to our corticosteroid series over 6 years (January 1, 2000-December 31, 2005).
Of 1188 patients patch tested to corticosteroid series, 127 (10.69%) had allergic reaction to at least one corticosteroid; 56 reacted to multiple corticosteroids. Rates of allergic patch test reaction to 19,611 individual corticosteroids were 0.41% to 5.03%. Rates of reaction to corticosteroid groups were 1.10% to 5.72%; concomitant reactions between groups were noted. Present screens on our standard series identified 74% of those detected on the corticosteroid series; tixocortol pivalate alone detected less than 50%.
Limitations include that this study was retrospective and the possible interobserver variation in interpretation of patch tests.
In patients suggested to have corticosteroid allergy, patch testing confirms allergy in 10.69%; allergy is often to multiple corticosteroids and across groups. Screens on a standard series may detect 74% of those detected on a corticosteroid series.
外用皮质类固醇过敏比之前认为的更为常见。为检测这种过敏，除了在标准系列上进行皮质类固醇筛查外，还使用皮质类固醇系列进行斑贴试验。
我们试图回顾我们对皮质类固醇系列进行斑贴试验的经验。
我们对2000年1月1日至2005年12月31日这6年间对皮质类固醇系列进行斑贴试验的情况进行了一项回顾性研究。
在1188名接受皮质类固醇系列斑贴试验的患者中，127名（10.69%）对至少一种皮质类固醇有过敏反应；56名对多种皮质类固醇有反应。对19611种个体皮质类固醇的斑贴试验过敏反应率为0.41%至5.03%。对皮质类固醇组的反应率为1.10%至5.72%；注意到组间有伴随反应。我们标准系列上目前的筛查发现了皮质类固醇系列中74%的检测病例；仅匹伐酸曲安西龙检测出的病例不到50%。
局限性包括本研究为回顾性研究以及斑贴试验解读中可能存在的观察者间差异。
在被怀疑有皮质类固醇过敏的患者中，斑贴试验证实过敏的比例为10.69%；过敏通常涉及多种皮质类固醇且跨组。标准系列的筛查可能检测出皮质类固醇系列中74%的检测病例。
