PEARLS IN DERMATOLOGY 

Giornale Italiano di Dermatologia e Venereologia 2012 February;147(1):65-9

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

New insights about delayed allergic hypersensitivity to corticosteroids

Baeck M. ¹, Goossens A. ² ✉

¹ Departement of Dermatology,, Saint-Luc University Clinic, Louvain Catholic University, Bruxelles, Belgium; ² Departement of Dermatology, University Hospital, Leuven Catholic University Hospital, Leuven, Belgium

Corticosteroids are among the most commonly used drugs, both topically and systemically. Although unexpected and paradoxical, allergic hypersensitivity to corticosteroids is a common finding, delayed-type reactions being much more frequently encountered than the immediate-type ones. With regard to cross-reactions between corticosteroids, based on patch-test results and molecular modelling, we were recently able to simplify the previous classification into 3 different groups, i.e., Group 1: the non-methylated, most often non-halogenated molecules (Group A, D2 and budesonide), which produce most of the allergic reactions; Group 2: the halogenated molecules with a C16/C17 cis ketal/diol structure (acetonide Group B); and Group 3: the halogenated and C16-methylated molecules (Group C and D1) that only rarely produce allergy.