Freeman S
Contact & Occupational Dermatitis Clinic, Skin and Cancer Foundation, Sydney, Australia.
Contact Dermatitis. 1995 Oct;33(4):240-2. doi: 10.1111/j.1600-0536.1995.tb00474.x.
Allergy to corticosteroids is becoming increasingly recognized. Diagnosis is difficult because of frequently false-negative patch tests. The optimum concentration and vehicle for patch testing with pure corticosteroid has still not been established. The patch test results of 19 patients with allergy to corticosteroids seen at the Skin and Cancer Foundation in Sydney, Australia, were analysed. It was found that patch testing with the patient's corticosteroid in the commercial cream base gave a greater yield of positive results than testing with the commercial corticosteroid ointment or with the pure corticosteroid in either petrolatum or in alcohol. Tixocortol pivalate, and to a lesser extent budesonide, were useful for detecting allergy to hydrocortisone, but not necessarily other corticosteroids. Delayed positive patch tests were often seen, showing the importance of carrying out a late reading. The repeat open application test (ROAT) with the patient's own corticosteroid was found to be a simple, useful diagnostic test.
对皮质类固醇的过敏正越来越多地被认识到。由于斑贴试验频繁出现假阴性，诊断很困难。用于纯皮质类固醇斑贴试验的最佳浓度和赋形剂尚未确定。对在澳大利亚悉尼皮肤与癌症基金会就诊的19例皮质类固醇过敏患者的斑贴试验结果进行了分析。结果发现，用市售乳膏基质中的患者皮质类固醇进行斑贴试验，比用市售皮质类固醇软膏或凡士林或酒精中的纯皮质类固醇进行试验，阳性结果的检出率更高。特戊酸替可的松，以及程度稍轻的布地奈德，可用于检测对氢化可的松的过敏，但不一定能检测对其他皮质类固醇的过敏。经常会出现延迟阳性斑贴试验结果，这表明进行延迟读数的重要性。发现用患者自身的皮质类固醇进行重复开放应用试验（ROAT）是一种简单、有用的诊断试验。
