IngentaConnect Type-IV hypersensitivity to betamethasone valerate and clobetasol...

Authors: Sommer, S.¹; Wilkinson, S.M.¹; English, J.S.C.²; Gawkrodger, D.J.³; Green, C.⁴; King, C.M.⁵; Powell, S.⁶; Sansom, J.E.⁷; Shaw, S.⁸

Source: British Journal of Dermatology, Volume 147, Number 2, August 2002 , pp. 266-269(4)

Publisher: Blackwell Publishing

Abstract:

Summary

Background Most studies investigating steroid allergy have been performed with tixocortol pivalate, hydrocortisone butyrate and budesonide. Betnovate^® and Dermovate^® are widely prescribed in the U.K. but little is known about the frequency of sensitization to them.

Objectives To determine the optimum method to detect contact allergy to betamethasone valerate (BV) and clobetasol propionate (CP).

Methods Seven centres tested consecutive patients attending for investigation of suspected allergic contact dermatitis to these steroids at a range of concentrations in different vehicles.

Results Of 1562 patients tested, 16 (1%) reacted to either BV or CP. Ten patients (0·7%) reacted to BV and 13 (0·8%) to CP. Two patients of a further centre were included in analysis of dilutions and vehicles. Sixteen of a total of 25 reactions (64%) were identified with a 1% dilution in ethanol.

Conclusions Consideration should be given to adding BV and CP to a standard allergy series, given that both are frequently used in the treatment of eczema and that most patients sensitized to them are not identified with currently used markers of steroid allergy. If patch tests to BV and CP are initially negative, but an allergy is suspected, the patient should be further investigated. Further studies are required to identify the ideal patch test material.

Keywords: allergic contact dermatitis; betamethasone valerate; clobetasol propionate; patch test method

Document Type: Research article

DOI: 10.1046/j.1365-2133.2002.04816.x

Affiliations: 1: Departments of Dermatology, Leeds General Infirmary, Leeds LS1 3EX, U.K. 2: Queen's Medical Centre, Nottingham NG7 2UH, U.K. 3: Royal Hallamshire Hospital, Sheffield S10 2JF, U.K. 4: Ninewells Hospital & Medical School, Dundee DD1 9SY, U.K 5: The Royal Liverpool University Hospitals, Liverpool L7 8XP, U.K. 6: Churchill Hospital, Oxford OX3 7LJ, U.K. 7: Bristol Royal Infirmary, Bristol BS2 8HW, U.K. 8: Amersham General Hospital, Amersham HP7 0JD, U.K.

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Type-IV hypersensitivity to betamethasone valerate and clobetasol propionate: results of a multicentre study