Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances. American journal of contact dermatitis : official journal of the American Contact Dermatitis Society. [Am J Contact Dermat] Journal article | | Title | Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances. | | Author(s) | Isaksson M, Bruze M, Lepoittevin JP, Goossens A | | Institution | Department of Occupational and Environmental Dermatology, Malmö University Hospital, Malmö, Sweden. | | Source | Am J Contact Dermat 2001 Sep; 12(3):170-6. | | MeSH | Allergens
Budesonide
Cross Reactions
Dermatitis, Allergic Contact
Dose-Response Relationship, Drug
Humans
Patch Tests
Research Support, Non-U.S. Gov't
Stereoisomerism
| | Abstract | BACKGROUND: Budesonide, a marker for corticosteroid allergy, is a 1:1 mixture of 2 diastereomers, the R and S, present in all commercial formulations. Budesonide is said to cross-react with group B substances through the R and S diastereomer and some group D substances only through the S diastereomer.
OBJECTIVE: To investigate the cross-reactivity pattern between the R and S diastereomers and 4 potentially cross-reacting substances, 2 from group B and 2 from group D.
METHODS: By patch testing 10 patients hypersensitive to budesonide with a serial dilution of budesonide, the R and S diastereomer, triamcinolone acetonide, amcinonide, prednicarbate, and hydrocortisone-17-butyrate.
RESULTS: Nine of 10 patients reacted to budesonide and the S diastereomer. Seven of 9 to the R diastereomer. Each of the 9 patients with S diastereomer allergy reacted to the group B and/or group D substances. Five patients reacted to triamcinolone acetonide, not to 1.0% but only to 0.0010% and 0.00010%.
CONCLUSION: The R and S diastereomers can induce positive patch test reactions in budesonide-hypersensitive individuals. The potential of budesonide to cross-react with substances from group B and D might be explained by the presence of the 2 diastereomers. When patch testing with triamcinolone acetonide, much lower concentrations than recommended should be used. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 11526524 |
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