Reacciones de hipersensibilidad a corticoides

A Case Report of Steroid-Induced Angioedema and Urticaria

Physicians regularly use corticosteroids to treat various conditions, attributing their anti-inflammatory and immunosuppressive properties. Cases of allergic sensitivity reactions and dermatitis induced by corticosteroids are relatively uncommon. We present a case regarding an 81-year-old male with a history of actinic keratosis, atopic dermatitis, and psoriasis, who experienced a Type I hypersensitivity reaction with facial angioedema and urticaria on his axilla, torso, and popliteal fossa that developed after treatment with oral prednisolone. This episode also exacerbated his previously diagnosed psoriasis. To treat psoriasis, a dermatologist prescribed clobetasol topical ointment, which did not alleviate the symptoms; instead, it only exacerbated the rash, and he was subsequently referred for corticosteroid allergy testing. North American 85 Comprehensive Series patch testing revealed a positive test for various classes of steroids, including clobetasol-17-propionate, budesonide, and dexamethasone, thus proving a T cell-mediated allergy to corticosteroids.

Guidelines for the Diagnosis, Treatment, and Prevention of Hand Eczema

Hand eczema is a common condition associated with significantly impaired quality of life and high social and occupational costs. Managing hand eczema is particularly challenging for primary care and occupational health physicians as the condition has varying causes and both disease progression and response to treatment are difficult to predict. Early diagnosis and appropriate protective measures are essential to prevent progression to chronic eczema, which is much more difficult to treat. Appropriate referral to a specialist and opportune evaluation of the need for sick leave are crucial to the good management of these patients. These guidelines cover the diagnosis, prevention, and treatment of chronic hand eczema and highlight the role that primary care and occupational health physicians can play in the early management of this disease.

Allergy against Steroids in Ocular Inflammation

Allergy to steroids is an uncommon and harmful condition that leads to a decrease in treatment options and increase in morbidity due to the suboptimal disease control. It can manifest as an immediate response or a delay manifestation. Worsening of underlying condition and not treatment response can indicate corticosteroids hypersensitivity as well. Despite its low prevalence, all clinicians should be aware of this condition and know the treatment options. This narrative review attempts to update information about corticosteroid allergy and we present a case of a patient with the diagnosis of Vogt Koyanagi Harada Syndrome with a history of steroids allergy, as an example, to integrate this information to the ocular inflammation field.

Drugs frequently involved in inducing hypersensitivity reactions

Adverse drug reactions represent a major public health problem, both from an economic point of view and, mainly, from the point of view of the induced pathology (iatrogenic diseases), being difficult to differentiate from other pathological conditions or even from the treated disease. Thus, these aspects prevent the use of the first-choice drugs needed for a particular treatment, in different therapeutic classes: beta-lactam antibiotics; sulfonamides; macrolide antibiotics; quinolones; non-steroidal anti-inflammatories; corticosteroids; Angiotensin converting enzyme (ACE) inhibitors; general anesthetics; biological drugs; antiepileptic drugs etc. On the other hand, adverse drug reactions represent a major problem for both clinical practice and preclinical research, in order to develop new drugs. Hypersensitivity reactions mainly refer to the adverse effects that can be harmful, disturbing, and sometimes fatal, that appear under the conditions of a normal immune system, including allergies and autoimmune reactions, both triggered by an immunological-allergic mechanism. The main purpose of this paper is to review the main classes of drugs involved in inducing hypersensitivity reactions.