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Topical corticosteroid allergy: Results of sequential testing to a corticosteroid series in New Zealand
Author(s) -
Murphy Victoria L.,
Patel Denesh C.,
Lamb Steven R.,
Cheng Harriet S.
Publication year - 2021
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/cod.13776
Subject(s) - corticosteroid , medicine , budesonide , sensitization , patch test , allergy , patch testing , population , retrospective cohort study , dermatology , contact dermatitis , immunology , environmental health
Background Our institution tests the European Baseline Series (EBS) and a steroid series sequentially in all patients presenting for patch testing. The rate of steroid sensitization in New Zealand has not previously been documented. Objectives To investigate the rate of corticosteroid sensitization and assess additional benefit of testing the full steroid series over the steroid allergy markers in the EBS. Methods/Patients Retrospective analysis of all patient demographics and patch test results over a 5‐year period (2014 to 2019) was performed at a tertiary patch test clinic in Auckland, New Zealand. Results A total of 319 patients completed patch testing, and 4.4% were sensitized to one or more corticosteroids. As much as 79% of positive reactions were of current relevance; 11/14 reactions were to tixocortol pivalate or budesonide. The “number needed to test” to detect one additional case of corticosteroid sensitization by using the full corticosteroid series over the EBS alone was 107. Conclusions Although corticosteroid sensitization was not uncommon in our population, the results suggest that sequential testing with the corticosteroid markers (budesonide and tixocortol) in the standard series alone is adequate. The additional corticosteroid series should be added if the markers are positive or where there is a clinical suspicion of corticosteroid allergy.