Detailed Information about Steroid Allergy
Corticosteroids are the medications that are widely used in treatment of diverse inflammatory conditions, including autoimmune and allergic disorders. Such medications are available in multiple forms, including oral, injectable, topical and inhaled. Unlike other formulas, topical hydrocortisone is available OTC in a mild dose. Generally, corticosteroids are used to eliminate the symptoms of allergic reactions, such as allergic rhinitis, asthma, contact dermatitis, angioedema, anaphylaxis, atopic dermatitis, urticaria and reactions to drugs, insect bites and certain foods.
Additionally, these drugs are administered for treatment of autoimmune complications, specifically rheumatoid arthritis and systemic lupus erythematosus.
Allergies to Topical Corticosteroids
Most frequently topical corticosteroids are used to eliminate the signs of allergic skin reactions, especially contact dermatitis and atopic dermatitis, though it can also be applied to the sites of insect bites and stings.
Corticosteroids can also be taken as inhaled medications in order to control asthma symptoms. Besides, it can be administered as an intranasal remedy to eliminate the signs of allergic rhinitis.
Allergic reactions to corticosteroid solutions may be quite difficult to diagnose, as aggravation of skin rash can be determined as worsening of the current condition, rather than an allergic reaction to the ingredients of the corticosteroid.
Intranasal and inhaled corticosteroids can trigger lung and nose irritation in the same way, which is blamed on the aggravating symptoms of allergic asthma or rhinitis. Intranasal and inhaled corticosteroids can stimulate the occurrence of other allergic reactions, including rashes on the body and face.
Patch testing is a dependable way to diagnose an allergic reaction to topical corticosteroids. In addition, a widely available TRUE test and its alternatives can show the reaction to common corticosteroids, including Tixocortol, Budesonide and others. Patch testing can show false results, since an anti-inflammatory reaction promoted by the medication suppresses allergic symptoms.
Allergies to Systemic Corticosteroids
Injection or oral forms of corticosteroids can belong to group of systemic medications, and allergic reactions to such drugs are rare, but if they occur, they can be ultimately dangerous and sometimes even life-threatening. Reactions to systemic corticosteroids can appear immediately or not. Immediate allergic reactions may appear within 30-60 minutes after the medication intake, while their symptoms will include anaphylaxis, asthma signs, angioedema and urticaria.
Instant reactions are caused mainly by IgE antibodies against corticosteroids, additives or preservatives within the medicine. To diagnose systemic corticosteroid allergy, a patient should undergo skin testing and RAST testing. Negative results should be proved by a drug challenge to make sure a patient will not develop allergies.
Non-immediate allergic reactions are mild and do not bear a potential threat to the health of a patient. The first signs of the disorder usually occur within 24-48 hours after the medicine use. Skin rashes and urticaria are the most common signs of allergic reactions.
Patch or skin testing can be performed in order to diagnose non-immediate allergic reactions to systemic corticosteroid, although, proper results of tests can be achieved only after 1-2 days, taking into account delayed nature of the reaction.
Due to a considerable amount of cross-reactivity between different corticosteroids for reactions to systemic and topical medications, testing should be performed with similar remedies to find an optimal corticosteroid, well-tolerated by the body.