Kot Marek, Bogaczewicz Jarosław, Kręcisz Beata, Woźniacka Anna
Department of Dermatology and Venereology, Medical University of Lodz, Lodz, Poland.
Faculty of Medicine and Health Science, Jan Kochanowski University, Kielce, Poland.
Postepy Dermatol Alergol. 2017 Jun;34(3):253-259. doi: 10.5114/ada.2017.67848. Epub 2017 May 29.
Clinical studies indicate that contact allergy to glucocorticosteroids (GCS) is not rare and has been increasingly reported over the past decade. Among the risk factors for developing contact hypersensitivity to topical corticosteroids, chronic inflammatory skin diseases and polyvalent contact allergy seem to be most important.
To present the structure of contact allergy in the population of patients with chronic inflammatory dermatoses (CID) and contact hypersensitivity to corticosteroids.
Twenty-seven patients with contact allergy to GCS and chronic inflammatory dermatoses were patch tested with 28 European Baseline Series allergens and 8 corticosteroid allergens. This study group consisted of 5 patients with atopic dermatitis (AD), 15 patients with contact eczema (CE) and 7 with chronic leg eczema (CLE). Nineteen (70.4%) patients were females and 8 (29.6%) were males.
In the study group, the most sensitizing non-steroidal allergens were nickel sulfate (51.8%), cobalt chloride (33.3%) and balsam of Peru (29.6%). The most sensitizing corticosteroid allergens were budesonide (77.8%), betamethasone valerate and clobetasol propionate (55.5% each). A total of 77.8% of patients allergic to GCS also showed sensitivity to at least one non-steroidal allergen from the European Baseline Series.
The most important risk factors for developing contact allergy to corticosteroids appear to be chronic inflammatory dermatoses, long disease duration, extended on-and-off topical corticosteroid use, patients presenting two or more positive patch test results and polyvalent contact allergy to metal salts and to other non-steroidal haptens.
临床研究表明，对糖皮质激素（GCS）的接触性过敏并不罕见，且在过去十年中报告日益增多。在发生局部糖皮质激素接触性超敏反应的风险因素中，慢性炎症性皮肤病和多价接触性过敏似乎最为重要。
呈现慢性炎症性皮肤病（CID）患者群体中接触性过敏及对糖皮质激素接触性超敏反应的结构。
对27例对GCS有接触性过敏且患有慢性炎症性皮肤病的患者，用28种欧洲基线系列变应原和8种糖皮质激素变应原进行斑贴试验。该研究组包括5例特应性皮炎（AD）患者、15例接触性湿疹（CE）患者和7例慢性腿部湿疹（CLE）患者。19例（70.4%）患者为女性，8例（29.6%）为男性。
在研究组中，致敏性最强的非甾体类变应原是硫酸镍（51.8%）、氯化钴（33.3%）和秘鲁香脂（29.6%）。致敏性最强的糖皮质激素类变应原是布地奈德（77.8%）、戊酸倍他米松和丙酸氯倍他索（各55.5%）。对GCS过敏的患者中，共有77.8%对欧洲基线系列中至少一种非甾体类变应原也敏感。
发生糖皮质激素接触性过敏的最重要风险因素似乎是慢性炎症性皮肤病、病程长、局部糖皮质激素长期断断续续使用、斑贴试验结果有两项或更多阳性的患者以及对金属盐和其他非甾体类半抗原的多价接触性过敏。
