Guin J D
J Am Acad Dermatol. 1984 May;10(5 Pt 1):773-82. doi: 10.1016/s0190-9622(84)70093-4.
Five cases of contact sensitivity to topical corticosteroids are described. Two of the five patients presented with chronic hand eczema that was nonresponsive to topical steroid therapy. The others had eruptions suggestive of contact dermatitis. One patient was allergic only to amcinonide , while the other reacted to multiple corticosteroids. Two of them were also sensitive to ethylenediamine. The level of sensitivity can be mild or severe, and some with mild patch test responses are allergic to multiple corticosteroids. These patients often have a history of chronic eczema, e.g., stasis dermatitis, and the presenting complaint ranges from a failure to heal to obvious contact dermatitis. Cross-reactions occur not infrequently (based on similarities in the structure of either the corticosteroid or the ester), but these patterns are probably not sufficiently reliable to use clinically without patch test confirmation. The only treatment required is removal from the offending agent(s) and substitution of a product that does not elicit a reaction on patch testing. The findings in ninety-five other case reports are reviewed, and a practical method for patch testing to these agents is presented.
本文描述了5例对局部用皮质类固醇的接触性敏感病例。5例患者中有2例表现为慢性手部湿疹，对局部类固醇治疗无反应。其他患者有提示接触性皮炎的皮疹。1例患者仅对安西奈德过敏，而另1例对多种皮质类固醇有反应。其中2例对乙二胺也敏感。敏感程度可轻可重，一些斑贴试验反应轻微的患者对多种皮质类固醇过敏。这些患者常有慢性湿疹病史，如淤积性皮炎，就诊主诉从伤口不愈合到明显的接触性皮炎不等。交叉反应并不少见（基于皮质类固醇或酯结构的相似性），但这些模式在未经斑贴试验证实的情况下可能不足以可靠地用于临床。唯一需要的治疗是去除致病因素，并替换在斑贴试验中不引起反应的产品。本文回顾了其他95例病例报告的结果，并提出了对这些药物进行斑贴试验的实用方法。
