Contact sensitization caused by topical corticosteroids (TC) is more frequent than previously suspected. Multiple positive patch test results to TC are frequently reported. According to cross-reactivity pattern, 4 groups of structurally related corticosteroids have been identified. Positive patch tests occur more frequently in one of these groups than between TC of different groups. Alternative TC should be chosen among those with chemical structure unrelated to the sensitizers. Mometasone furoate (MF) is a recently marketed TC characterized by an ester group at C17 and C21. This molecular structure has been related to a weak sensitizing activity when compared with other TC. In order to evaluate the sensitizing capacity, 473 patients affected by contact dermatitis were patch tested with MF 1% pet. and eth. added to standard series. Moreover, 13 patients with patch test proven contact sensitisation to various TC (budesonide, hydrocortisone-17-butyrate, tixocortol pivalate) were patch tested with MF 1% pet. and eth. None of all these patients reacted to MF. Maximization test with MF was performed in 25 healthy volunteers. MF was not able to induce contact sensitization in all the 25 patients. Our data seems to confirm that MF has a weak sensitising capacity. On the other hand, MF seems not to cross-react with other TC, and specially with budesonide, hydrocortisone-17-butyrate, and tixocortol pivalate which are considered as markers of contact allergy to TC. In conclusion, MF could be considered as one of the alternatives for the topical treatment of cutaneous inflammatory disease in patients with contact sensitization to TC.
Allergic contact sensitivity to topical corticosteroids: Cross-reactions and therapeutical alternatives
Patruno C.;
2001-01-01
Abstract
Contact sensitization caused by topical corticosteroids (TC) is more frequent than previously suspected. Multiple positive patch test results to TC are frequently reported. According to cross-reactivity pattern, 4 groups of structurally related corticosteroids have been identified. Positive patch tests occur more frequently in one of these groups than between TC of different groups. Alternative TC should be chosen among those with chemical structure unrelated to the sensitizers. Mometasone furoate (MF) is a recently marketed TC characterized by an ester group at C17 and C21. This molecular structure has been related to a weak sensitizing activity when compared with other TC. In order to evaluate the sensitizing capacity, 473 patients affected by contact dermatitis were patch tested with MF 1% pet. and eth. added to standard series. Moreover, 13 patients with patch test proven contact sensitisation to various TC (budesonide, hydrocortisone-17-butyrate, tixocortol pivalate) were patch tested with MF 1% pet. and eth. None of all these patients reacted to MF. Maximization test with MF was performed in 25 healthy volunteers. MF was not able to induce contact sensitization in all the 25 patients. Our data seems to confirm that MF has a weak sensitising capacity. On the other hand, MF seems not to cross-react with other TC, and specially with budesonide, hydrocortisone-17-butyrate, and tixocortol pivalate which are considered as markers of contact allergy to TC. In conclusion, MF could be considered as one of the alternatives for the topical treatment of cutaneous inflammatory disease in patients with contact sensitization to TC.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
