Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
J Korean Med Sci. 2018 Mar 19;33(12):e87. doi: 10.3346/jkms.2018.33.e87.
Corticosteroids are potent anti-inflammatory and anti-allergic agents used in the treatment of various inflammatory diseases, including allergic disease. They are frequently considered the therapy-of-choice for many skin diseases. However, allergic reactions caused by corticosteroids have been reported. Among these, delayed reactions to topical steroids are more common, whereas immediate reactions to systemic steroids are rare. Herein, we report the case of a 32-year-old woman with triamcinolone-induced immediate hypersensitivity reaction, in which the patient had a positive prick test result with triamcinolone. She has had atopic dermatitis (AD) for three years. She had used systemic steroid, cyclosporine, and antihistamine with topical steroids for AD. In clinic, approximately 10 minutes after intralesional injection of triamcinolone, she complained of erythematous patches with slight elevation and itching on the face, trunk, and both hands. After intravenous injection of dexamethasone, her symptoms got worse. After treatment with epinephrine, all symptoms resolved within two hours. We performed an open test and skin prick test. She had a positive result only from the prick test with triamcinolone; all other steroids showed negative results from the open tests. Dermatologists should be aware of the possibility of anaphylaxis or other allergic hypersensitivity in response to corticosteroids.
皮质类固醇是一种强效的抗炎和抗过敏药物，用于治疗各种炎症性疾病，包括过敏疾病。它们经常被认为是许多皮肤病的首选治疗方法。然而，已经报道了皮质类固醇引起的过敏反应。其中，局部类固醇的迟发性反应更为常见，而全身性类固醇的即刻反应则较为罕见。在此，我们报告了一例 32 岁女性因曲安奈德引起的即刻过敏反应病例，患者对曲安奈德的划痕试验结果呈阳性。她患有特应性皮炎（AD）已有三年。她曾使用过全身性类固醇、环孢素和抗组胺药以及局部类固醇治疗 AD。在临床中，曲安奈德皮内注射后约 10 分钟，她的面部、躯干和双手出现红斑，略有隆起，伴有瘙痒。静脉注射地塞米松后，她的症状恶化。给予肾上腺素治疗后，所有症状在两小时内得到缓解。我们进行了开放性试验和皮肤划痕试验。她只有曲安奈德的划痕试验结果呈阳性；所有其他类固醇的开放性试验结果均为阴性。皮肤科医生应该意识到对皮质类固醇产生过敏反应或其他过敏反应的可能性。
