Dunkel F G, Elsner P, Burg G
Department of Dermatology, University of Würzburg, Germany.
Contact Dermatitis. 1991 Aug;25(2):97-103. doi: 10.1111/j.1600-0536.1991.tb01796.x.
Patients who noticed worsening of their skin disease after using topical corticosteroid preparations were patch tested both with the commercial preparation and the corticosteroid itself. Between 1987 and 1989, 10 cases of contact dermatitis due to topical corticosteroids were detected in this way. The corticosteroids wee amcinonide (2 patients), hydrocortisone butyrate, clobetasol propionate (2), betamethasone valerate (2), prednicarbate and fluocortolone (2). Patch tests with the commercial preparations and the corticosteroids themselves elicited reactions almost identical in time course and severity. Individual sensitivity seems to be more important for test results than test conditions. 9 of the 10 patients underwent further patch testing with a corticosteroid series. In 2 patients, a true cross-reaction between budesonide and hydrocortisone butyrate was found. All 9 patients showed further sensitivities to other corticosteroids. Most of the cross or concomitant reactions could be categorized into recently defined corticosteroid classes. To improve our understanding of corticosteroid sensitization, and to help the patient avoid reactions to other topical corticosteroids, a corticosteroid series should be patch tested in every case of corticosteroid sensitivity.
在使用外用皮质类固醇制剂后发现皮肤病加重的患者，接受了针对市售制剂和皮质类固醇本身的斑贴试验。在1987年至1989年期间，通过这种方式检测到10例由外用皮质类固醇引起的接触性皮炎病例。这些皮质类固醇为安西奈德（2例患者）、丁酸氢化可的松、丙酸氯倍他索（2例）、戊酸倍他米松（2例）、泼尼松卡酯和氟可龙（2例）。对市售制剂和皮质类固醇本身进行的斑贴试验引发的反应在时间进程和严重程度上几乎相同。个体敏感性对试验结果似乎比试验条件更重要。10名患者中的9名接受了进一步的皮质类固醇系列斑贴试验。在2例患者中，发现布地奈德和丁酸氢化可的松之间存在真正的交叉反应。所有9名患者对其他皮质类固醇均表现出进一步的敏感性。大多数交叉或伴随反应可归类为最近定义的皮质类固醇类别。为了增进我们对皮质类固醇致敏的理解，并帮助患者避免对其他外用皮质类固醇产生反应，对于每一例皮质类固醇敏感性病例，均应进行皮质类固醇系列斑贴试验。
