PMID- 20502322
OWN - NLM
STAT- MEDLINE
DCOM- 20101021
LR  - 20100708
IS  - 1473-6322 (Electronic)
IS  - 1473-6322 (Linking)
VI  - 10
IP  - 4
DP  - 2010 Aug
TI  - Hypersensitivity reactions to corticosteroids.
PG  - 273-9
LID - 10.1097/ACI.0b013e32833b1f34 [doi]
AB  - PURPOSE OF REVIEW: To describe the clinical entities, underlying mechanisms and 
      diagnostic approach of hypersensitivity reactions to corticosteroids, emphasizing 
      new data concerning hypersensitivity reactions to systemically administered 
      corticosteroids. RECENT FINDINGS: Reactions after topical corticosteroid 
      administration to the skin have been known for decades, appearing as an 
      eczematous lesion and with diagnosis by patch testing. However, new data have 
      appeared about cutaneous symptoms after inhaled and systemically administered 
      corticosteroids. In fact, T-cell involvement in a generalized maculopapular 
      exanthema induced by inhaled budesonide has recently been demonstrated by 
      lymphocyte transformation tests. Moreover, T-cell involvement has also been shown 
      in skin biopsies from a group of patients with urticaria and maculopapular 
      exanthema after systemically administered corticosteroids, with detection of a 
      significant increase in the expression of interferon-gamma (IFN-gamma) and tumor 
      necrosis factor-alpha (TNF-alpha), and a significant decrease in interleukin-4 
      and GATA-3 when samples obtained during the drug provocation test reaction were 
      compared with samples from the resolution phase. In immediate allergic reactions 
      to corticosteroids, an immunoglobulin E (IgE) response has recently been shown by 
      skin testing, ImmunoCAP and basophil-activation tests. SUMMARY: Generalized 
      cutaneous symptoms after corticosteroid administration occur with both IgE and 
      T-cell involvement. Skin testing, in-vitro testing and drug provocation tests are 
      useful diagnostic tools.
FAU - Torres, Maria J
AU  - Torres MJ
AD  - Allergy Service, Carlos Haya Hospital, Malaga, Spain. mjtorresj@gmail.com
FAU - Canto, Gabriela
AU  - Canto G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Curr Opin Allergy Clin Immunol
JT  - Current opinion in allergy and clinical immunology
JID - 100936359
RN  - 0 (Adrenal Cortex Hormones)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adrenal Cortex Hormones/administration & dosage/*adverse effects
MH  - *Drug Hypersensitivity/diagnosis/epidemiology/immunology/physiopathology
MH  - Humans
MH  - Immunoglobulin E/blood
MH  - Skin Tests/methods
MH  - T-Lymphocytes/immunology
EDAT- 2010/05/27 06:00
MHDA- 2010/10/22 06:00
CRDT- 2010/05/27 06:00
PHST- 2010/05/27 06:00 [entrez]
PHST- 2010/05/27 06:00 [pubmed]
PHST- 2010/10/22 06:00 [medline]
AID - 10.1097/ACI.0b013e32833b1f34 [doi]
PST - ppublish
SO  - Curr Opin Allergy Clin Immunol. 2010 Aug;10(4):273-9. doi: 
      10.1097/ACI.0b013e32833b1f34.