Almond-Roesler B, Blume-Peytavi U, Orfanos C E
Universitäts-Hautklinik und Poliklinik, Klinikum Benjamin Franklin, Freien Universität Berlin.
Hautarzt. 1995 Apr;46(4):228-33. doi: 10.1007/s001050050245.
Topical corticosteroids (CS) are frequently used to treat of allergic contact dermatitis, so that their own potential for sensitization is rarely detected. However, increasing numbers of hypersensitivity reactions to corticosteroids have been reported during the last 10 years, and allergic skin reactions to over 50 particular compounds have been observed. CS must now be regarded as a rather frequent contact allergen, the prevalence being twice as high in women as in men. Contact allergy to CS is clinically characterized by a chronic and persistent, corticosteroid-resistant dermatitis. In general, hypersensitivity to CS is a type I and/or type IV mediated allergic reaction. Cross-sensitivity between individual corticosteroid preparations has been described owing to their closely related chemical structures (e.g. hydrocortisone and tixocortol pivalate). Contact allergy to CS can be confirmed by patch-tests, intradermal injection tests or application tests; because of the delayed appearance of positive skin reactions a prolonged evaluation period of up to 120 h is recommended. For routine screening the use of the patient's own material and of tixocortol pivalate and budesonide as test marker substances seems appropriate. The development of further marker substances is a target for ongoing research.
外用糖皮质激素（CS）常用于治疗过敏性接触性皮炎，因此其自身的致敏潜力很少被检测到。然而，在过去10年中，对糖皮质激素过敏反应的报道越来越多，并且已经观察到对50多种特定化合物的过敏性皮肤反应。现在必须将CS视为一种相当常见的接触性变应原，其患病率女性是男性的两倍。对CS的接触性过敏在临床上表现为慢性持续性、糖皮质激素抵抗性皮炎。一般来说，对CS的超敏反应是由I型和/或IV型介导的过敏反应。由于个别糖皮质激素制剂的化学结构密切相关（如氢化可的松和匹伐替可的松），已描述了它们之间的交叉敏感性。对CS的接触性过敏可通过斑贴试验、皮内注射试验或应用试验来确诊；由于皮肤阳性反应出现延迟，建议延长评估期至120小时。对于常规筛查，使用患者自身材料以及匹伐替可的松和布地奈德作为试验标记物质似乎是合适的。开发更多的标记物质是正在进行的研究目标。
