- Although allergic reactions to corticosteroids do occur, they are, in the vast majority of times, due to intravenous or intramuscular injection.
- Patients can also develop hypersensitivity reactions to nasal, inhaled, oral, and parenteral CS
- reactions occur more frequently in asthmatic subjects and in patients regularly treated with systemic CSs(e.g. in the case of a missing or transplanted kidney) than in other subjects.
- However, in these cases, it is difficult to determine whether the higher incidence of allergies observed is due to increased susceptibility, or to greater exposure to CSs.
- Other factors such as hypersensitivity to salicylic acid might also constitute risk factors ; neither can genetic predisposition to CS allergies be excluded
- The incidence reported in the literature varies between 0.5% to 6%
- People with chronic eczema who require multiple prescriptions of topical steroids are at increased risk of becoming sensitized to topical steroids
- Risk factors for immediate corticosteroids allergy
- Patients requiring repeated doses of steroids e.g., renal transplant patients, severe asthmatics
- Aspirin sensitivity
- Female sex
- Risk factors for allergic contact dermatitis (delayed hypersensitivity) to corticosteroids
- Chronic nonhealing dermatitis / eczema
- Stasis dermatitis
- Chronic hand eczema
- Having allergic contact dermatitis to other chemicals
- There is an antigenic classification of corticosteroids based on their cross-reactivity related to contact dermatitis reactions.
- Although this deals with delayed hypersensitivity, it could perhaps give one a guide as to what corticosteroid might exhibit the least chance of cross-reacting with
- Corticosteroids with lower risk of sensitization
- Group C,
- The metylated and halogenated members of Group D,
- Newer synthetic steroids like Fluticasone propionate (cutivate) and mometasone furorate (Elocon) have a lower risk of sensitization
References:
- http://www.allergyclinic.co.nz/corticosteroid_allergy.aspx
- https://www.aaaai.org/ask-the-expert/allergic-reaction-prednisone
- https://www.ncbi.nlm.nih.gov/pubmed/23567983
- https://www.ncbi.nlm.nih.gov/pubmed/11456363
- Allergic hypersensitivity to topical and systemic corticosteroids:
a review. 2009 John Wiley & Sons A/S Allergy 2009: 64: 978–994
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