Lauerma A I, Tarvainen K, Forström L, Reitamo S
Department of Dermatology, Helsinki University Central Hospital, Finland.
Contact Dermatitis. 1993 Jan;28(1):10-4. doi: 10.1111/j.1600-0536.1993.tb03317.x.
It has been suggested that contact allergy to hydrocortisone alcohol is a frequent phenomenon. A recent study showed that all patients with allergic patch reactions to tixocortol pivalate reacted to intradermal hydrocortisone sodium phosphate. We studied patients with positive patch test reactions to tixocortol pivalate but negative to hydrocortisone alcohol, with penetration enhancers in hydrocortisone alcohol patch tests and oral challenges with hydrocortisone alcohol. Additionally, prick and intradermal tests with hydrocortisone sodium succinate were used. Using penetration enhancers and oral challenges enabled detection of more contact allergies to hydrocortisone alcohol compared to conventional patch testing alone. 9/12 patients with allergic reactions to tixocortol pivalate reacted to intradermal hydrocortisone sodium succinate. No immediate reactions were seen in prick or intradermal tests, suggesting that hydrocortisone contact hypersensitivity is probably not associated with immediate allergy to hydrocortisone. The present study suggests that allergic patch test reactions to tixocortol pivalate are caused by hypersensitivity to hydrocortisone alcohol itself or to one of its metabolites in the skin.
有人认为对氢化可的松酒精的接触性过敏是一种常见现象。最近一项研究表明，所有对匹伐酸曲安西龙有过敏性斑贴反应的患者对磷酸氢化可的松钠皮内注射均有反应。我们研究了对匹伐酸曲安西龙斑贴试验呈阳性但对氢化可的松酒精呈阴性的患者，在氢化可的松酒精斑贴试验中使用渗透促进剂并进行氢化可的松酒精口服激发试验。此外，还使用了氢化可的松琥珀酸钠的点刺试验和皮内试验。与单独使用传统斑贴试验相比，使用渗透促进剂和口服激发试验能够检测出更多对氢化可的松酒精的接触性过敏。12名对匹伐酸曲安西龙有过敏反应的患者中有9名对氢化可的松琥珀酸钠皮内注射有反应。在点刺试验或皮内试验中未观察到即刻反应，这表明氢化可的松接触性超敏反应可能与对氢化可的松的即刻过敏无关。本研究表明，对匹伐酸曲安西龙的过敏性斑贴试验反应是由对氢化可的松酒精本身或其在皮肤中的一种代谢产物过敏引起的。
