Wilkinson M, Hollis S, Beck M
Skin Hospital, Salford, U.K.
J Am Acad Dermatol. 1995 Dec;33(6):963-8. doi: 10.1016/0190-9622(95)90287-2.
Corticosteroid cross-reactions have been classified into four well-defined groups. A previous study of patch test reactions to other corticosteroids in patients allergic to hydrocortisone failed to conform to these groups. It was suggested that substitution at the C6 and C9 positions of the corticosteroid was the most important determinant of a further reaction.
Our aim was to analyze multiple positive patch tests to corticosteroids in patients sensitized to budesonide to confirm our earlier findings.
Forty-six patients with positive patch tests to budesonide were patch-tested to 17 other topical corticosteroids. The results were examined by a generalized linear model and a chi-square test.
Substitution of the corticosteroid at the C6 and C9 positions significantly reduced the number of reactions. A different substitution at the C16 and C17 positions was less important, and that at the C21 position was of no significance.
Patients sensitized to budesonide are most likely to react to other non-C6 and non-C9 substituted corticosteroids.
皮质类固醇交叉反应已被分为四个明确的组。先前一项针对氢化可的松过敏患者对其他皮质类固醇的斑贴试验反应的研究并不符合这些组。有人提出，皮质类固醇C6和C9位的取代是进一步反应的最重要决定因素。
我们的目的是分析对布地奈德致敏患者对皮质类固醇的多次阳性斑贴试验，以证实我们早期的发现。
对46例布地奈德斑贴试验阳性的患者进行另外17种外用皮质类固醇的斑贴试验。通过广义线性模型和卡方检验对结果进行分析。
皮质类固醇在C6和C9位的取代显著减少了反应的数量。C16和C17位的不同取代不太重要，而C21位的取代则无显著意义。
对布地奈德致敏的患者最有可能对其他未在C6和C9位取代的皮质类固醇产生反应。
