Mathelier-Fusade P, Marinho E, Aissaoui M, Mounedji N, Chabane M H, Leynadier F
Centre d'Allergie, Hôpital Rothschild, Paris.
Ann Dermatol Venereol. 1996;123(8):453-5.
Allergic reactions to general corticosteroid therapy are uncommon.
We report a patient with systemic lupus erythematousus who developed skin rash after initiation of prednisone then prednisolone therapy. Histology evidence suggested leukocytoclastic vasculitis. The skin tests (prick tests, intradermoreactions and patch-tests) using a battery of injectable corticosteroids showed a highly positive reaction to prednisolone, methylprednisolone and dexamethasone on the intradermo-reactions 24 hours later. Histology examination of a positive-response showed leukocytoclastic vasculitis associated with eczematiform alterations of the epidermis compatible with a drug reaction. The skin tests however were negative for betamethasone, triamcinolone, paramethasone and hydrocorticose. The patient was treated with betamethasone and no skin reaction was observed.
Skin tests, particularly intradermo-reactions read 24 hours later would appear to be useful in identifying possible cross-sensitivity.
对全身用皮质类固醇疗法的过敏反应并不常见。
我们报告一名系统性红斑狼疮患者，在开始使用泼尼松然后是泼尼松龙治疗后出现皮疹。组织学证据提示白细胞破碎性血管炎。使用一系列可注射皮质类固醇进行的皮肤试验（点刺试验、皮内反应和斑贴试验）显示，在24小时后的皮内反应中，对泼尼松龙、甲泼尼龙和地塞米松呈高度阳性反应。对阳性反应部位的组织学检查显示白细胞破碎性血管炎，伴有与药物反应相符的表皮湿疹样改变。然而，皮肤试验对倍他米松、曲安奈德、对氟米松和氢化可的松呈阴性。该患者接受倍他米松治疗，未观察到皮肤反应。
皮肤试验，尤其是24小时后读取结果的皮内反应，似乎有助于识别可能的交叉敏感性。
