Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Allergy. 2012 Dec;67(12):1580-5. doi: 10.1111/all.12041. Epub 2012 Oct 4.
Although unexpected and paradoxical, allergic hypersensitivity to corticosteroids is a common finding, delayed-type reactions being much more frequently encountered than the immediate-type ones. Although the skin is the main sensitization and elicitation route, other routes, amongst them systemic administration of corticosteroids may exceptionally be involved.
To determine the frequency, clinical presentation and cross-reactivity patterns for allergic reactions following systemic administration of corticosteroids amongst patients with identified and investigated 'contact allergy' to corticosteroids.
We reviewed clinical data, 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.
Sixteen subjects (out of 315 with CS delayed-type hypersensitivity) presented with allergic manifestations due to systemic administration of corticosteroids. Most patients reacted to molecules from the three groups of the recently reappraised classification.
The reactions observed seem to be in most cases 'systemic contact dermatitis' due to oral or parenteral re-exposure of sensitized individuals with the respective corticosteroids previously applied topically. Moreover, most patients seem to be able to react to any corticosteroid molecules and therefore need a systematic individualized evaluation of their sensitization/tolerance profile.
尽管出乎意料且自相矛盾，但皮质类固醇过敏是一种常见现象，迟发型反应比速发型反应更为常见。虽然皮肤是主要的致敏和激发途径，但其他途径，包括皮质类固醇的全身给药，也可能会涉及其中。
确定在已知并研究过“皮质类固醇接触过敏”的患者中，全身性皮质类固醇给药后发生过敏反应的频率、临床表现和交叉反应模式。
我们回顾了在 18 年期间，在鲁汶大学皮肤科接受皮质类固醇测试后呈阳性反应的患者的临床数据、斑贴试验结果和致敏源。
16 名受试者（315 名皮质类固醇迟发型超敏反应患者中的 16 名）因全身性皮质类固醇给药出现过敏表现。大多数患者对最近重新评估分类的三组分子产生反应。
观察到的反应在大多数情况下似乎是“全身性接触性皮炎”，因为先前局部应用的相应皮质类固醇再次经口服或肠胃外途径暴露于致敏个体。此外，大多数患者似乎能够对任何皮质类固醇分子产生反应，因此需要对其致敏/耐受性进行系统的个体化评估。
