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SELECTED ARTICLES FROM THE RECENT LITERATURE 2007
August 7, 2007
Contact dermatitis from topical corticosteroids
Summary
Background – One would not expect topical corticosteroid (CS) agents to induce contact dermatitis (CD) because of the frequently potent anti-inflammatory effects of such CS preparations. Yet such CD reactions to CS are suspected in some cases. Does patch testing with topical CS agents help in investigation?.
Findings – Davis et al reviewed their experience with CS patch testing in the Mayo Clinic of 1,188 patients patch tested during 2000-2005 with a panel of CS agents, Positive reactions to at least one CS were seen in 127 individuals with
56 reacting to more than one CS. The rates of reaction varied with different CS agents (1.1 to 5.7%). Of those reacting to at least one of the CS agents, 74% would have been detected using the CS screening test present in their standard patch test screening panel.
Reference
J Am Acad Dermatol 2007;50:921-7
Editor's Comments
The authors’ assumption that a “positive” patch test to a CS agent indicated clinical sensitivity is an over reach in my opinion, especially since this was a retrospective analysis. It would have been of considerable value to: 1) do therapeutic challenges with CS agents inducing positive and negative patch tests; 2) do control patch tests with the composite of “inactive” ingredients
(e.g., expedients, coloring materials) present besides the CS in the therapeutic preparations.
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