Allergic reactions to inhalant glucocorticosteroids: A hot topic for pneumologists and allergologists

Immunopharmacology and Immunotoxicology

Volumn 28, Issue 3, 2006, Pages 511-534

  Nettis, E ^a,c   Colanardi, M C ^a   Calogiuri, G F ^b   Ferrannini, A ^a   Vacca, A ^a   Tursi, A ^a  

^a UNIVERSITY OF BARI   (Italy)

^b VITO FAZZI HOSPITAL   (Italy)

^c POLICLINICO   (Italy)

Author keywords

Adverse Drug Reaction; Allergic Contact Dermatitis; Allergic Cross Sensitivity; Cough; Dyspnea; Inhalant Corticosteroids; Patch Tests

Indexed keywords

BECLOMETASONE DIPROPIONATE; BETA 2 ADRENERGIC RECEPTOR STIMULATING AGENT; BETAMETHASONE; BETAMETHASONE VALERATE; BRONCHODILATING AGENT; BUDESONIDE; CLOBETASOL PROPIONATE; CLOBETASONE; CORTISONE; DESONIDE; DEXAMETHASONE; FLUNISOLIDE; FLUTICASONE PROPIONATE; GLUCOCORTICOID; HALCINONIDE; HYDROCORTISONE; HYDROCORTISONE ACETATE; HYDROCORTISONE BUTYRATE; HYDROCORTISONE SODIUM PHOSPHATE; METHYLPREDNISOLONE; METHYLPREDNISOLONE ACETATE; METHYLPREDNISOLONE SODIUM SUCCINATE; MOMETASONE FUROATE; PREDNISOLONE; PREDNISOLONE ACETATE; PREDNISOLONE SODIUM PHOSPHATE; PREDNISONE; TIXOCORTOL PIVALATE; TRIAMCINOLONE ACETONIDE; UNINDEXED DRUG;

ALLERGIC CONTACT DERMATOMUCOSITIS; ALLERGIC CONTACT SENSITIZATION; ALLERGIC CROSS SENSTIVITY; ALLERGIC REACTION; ALLERGIC RHINOCONJUNCTIVITIS; ANAPHYLAXIS; ASTHMA; BRONCHOSPASM; CANDIDIASIS; CONTACT SENSITIZATION; COUGHING; CROSS REACTION; CYANOSIS; DELAYED HYPERSENSITIVITY; DERMATITIS; DERMATOMUCOSITIS; DISEASE EXACERBATION; DRUG CONFORMATION; DRUG HYPERSENSITIVITY; DRUG METABOLISM; DRUG STRUCTURE; DYSPHONIA; DYSPNEA; ECZEMA; HUMAN; HYPERTRICHOSIS; HYPOXIA; IMMUNOLOGY; INCIDENCE; MUCOSA INFLAMMATION; NASAL BURNING SYMPTOM; NASAL PRURITUS; NOSE CONGESTION; NOSE DISEASE; NOSE OBSTRUCTION; NOSE SEPTUM PERFORATION; OROPHARYNGEAL INFECTION; OROPHARYNX; PARADOXICAL PULSE; PATCH TEST; PATHOGENESIS; PHARYNGODYNIA; PHARYNGOTRACHEAL STRIDOR; PREVALENCE; PRICK TEST; PRIORITY JOURNAL; PURPURA; RASH; REVIEW; RHINITIS; RHINOCONJUNCTIVITIS; RHINORRHEA; RISK FACTOR; SKIN ALLERGY; SKIN DISEASE; SKIN THINNING; SORE THROAT; STEROID SKIN; STRIDOR; STRUCTURE ANALYSIS;

ADMINISTRATION, INHALATION; ALLERGY AND IMMUNOLOGY; CROSS REACTIONS; DELIVERY OF HEALTH CARE; DERMATITIS, ALLERGIC CONTACT; DRUG HYPERSENSITIVITY; GLUCOCORTICOIDS; HUMANS; MOLECULAR STRUCTURE;

EID: 33749038349     PISSN: 08923973     EISSN: 15322513     Source Type: Journal    
DOI: 10.1080/08923970600927827     Document Type: Review

References (111)

1. De Swarte, R.D.; Petterson R. Drug allergy. In Allergic Diseases Diagnostic and Management. Petterson, R., Grammer, L.C., Grenberger, P. Eds.; Lippincot-Raven: Philadelphia, 1997; 317-412.
2. Guillot, B. Adverse skin reactions to inhaled corticosteroids. Expert Opin. Drug Saf. 2002, 1, 329.
3. Bryant, D.H.; Pepys, J. Bronchial reactions to aerosol inhalant vehicle. Br. J. Med. 1976, 1, 1319.
4. Godin, J.; Malo, J. Acute bronchocostrition caused by Beclovent and not Vanceril. Clin. All. 1979, 9, 589.
5. Shim, C.S.; Williams, M.H. Cough and wheezing after inhalation of beclomethasone dipropionate aerosol in asthma. Chest 1987, 91, 209.
6. Shim, C.S.; Williams, M.H. Coughing and wheezing from beclomethasone dipropionate aerosol are absent after triamcinolone acetonide. Ann. Intern. Med. 1987, 106, 703.
7. Facchini, G.; Antonicelli, L.; Cinti, B.; Bonifazi, F.; Massei V. Paradoxical bronchospasm and cutaneous rash after metered-dose inhaled bronchodilators. Monaldi. Arch. Chest Dis. 1996, 51 (3), 203.
8. Silvastri, M.; Kohtamaki, K.; Lehtonen, L.; Vidgren, M.; Wenz, W. Tolerability of two surfactants in beclomethasone inhalation aerosol formulations in patients with asthma. Drug Invest. 1992, 4; 315.
9. Charpin, D.; Beaupe, A.; Orehek, J. Deep-inspiration induced bronchocostition: a mechanism for beclomethasone aerosol intolerance. Eur. J. Respir. 1986, 64, 497.
10. Clark, R.J. Exacerbation of asthma after nebulised beclomethasone dipropionate. Lancet 1986, 2, 575.
11. Poh, S.C.; Wang, Y.T. Severe bronchocostrition after inhalation of beclomethasone and budesonide. Sing. Med. J. 1986, 27, 249.
12. McGivern, D.V.; McFarlane, J.T. Severe bronchocostrition after inhalation of budesonide. Br. Med. J. 1984, 288, 447.
13. Miranda, A.; Garcia, J.J.; Torres, M.J.; del Cano, A.; Rondon, C.; Aguillar, F.; Carmona, M.J.; Vega, J.M. Bronchospasm reaction induced by inhaled budesonide (abstract). Allergy 1993, 48, 148.
14. Rajan T.V. The Gell-Coombs classification of hypersensitivity reactions: a reinterpretation. Trends Immunol. 2003, 24, 376.
15. Belsito, D.V. A sherlockian approach to contact dermatitis. Dermatol. Clin. 1999, 17, 712.
16. Wilkinson, S.M.; English, J.S.C.; Mattey, D.L. In vitro evidence of delayed-type hypersensitivity to hydrocortisone. Cont. Derma. 1993, 29, 245.
17. Scala, E.; Giani, M.; Pastore, S.; Pallotta, S.; Guerra, E.C.; Pirrotta, L.; Locanto, M.L.; Frezzolini, A.; DePità, O.; Puddu, P. Distinct delayed T-cell response to betamethasone and penicillin G in the same patient. Allergy 2003, 58, 444.
18. Boujnah-Kouadja, A.; Brandi, E.I.; Reuter, G.; Foussereau, J. Allergy to 2 new corticoid molecules. Cont. Dermat. 1984, 11, 87.
19. Bircher, A.J.; Hirsbrunner, P.; Tschopp, K.; Wildermuth, V. Allergic contact dermatitis from tixocortol pivalate in a nasal spray masquerading as infectious complication of sinusitis. J. Otorhinolaryng. Relat. Spec. 1995, 57, 56.
20. Camarsa, J.G.; Malet, A.; Serra-Baldrich, E.; Luch, M. Contact allergy to tixocotol pivalate. Cont. Dermat. 1988, 19, 1247.
21. Bircher, A.J.; Pelloni, F.; Langauer, Messner, S.; Muller, D. Delayed hypersensitivity reactions to corticosteroids applied to mucous membranes. Br. J. Dermatol. 1996, 135, 313.
22. Jelen, G. Un noveau cas d'allergie au tixocortol pivalate. Allergiè croissèe avec l'hydrocotisone. Lettre de Gerda 1986, 3, 29.
23. Bircher, A.J. Short induction phase of contact allergy to tixocortol pivalate. Cont. Dermat. 1990, 22, 238.
24. Hausen, B.M., Fossereau, J. The sensitizing capacity of tixocortol pivalate. Cont. Dermat. 1988, 18, 64.
25. Doble, N. Reaction to beclomethasone dipropionate nasal spray. Br. Med. J. 1985, 290, 518.
26. Tani, A.; Miyoshi, H.; Kanzaki, T. Allergic contact dermatitis due to beclomethasone dipropionate in an inhalant for asthma. Cont. Dermat. 2000, 43, 363.
27. Cooper, S.M.; Shaw, S. Contact allergy to beclomethasone dipropionate. Cont. Dermat. 1998, 39, 271.
28. Meding, B.; Dahlberg, E. Contact allergy to budesonide in a nasal spray. Cont. Dermat. 1986, 14, 254.
29. Gamboa, P.M.; Jauregui, I.; Antepara, I. Contact dermatitis from budesonide in a nasal spray without cross-reactivity to amcinonide. Cont. Dermat. 1991, 24, 228.
30. Jorro, G.; Rochina, A.; Morales, C. Contact allergy to topical budesonide in a nasal spray. Cont. Dermat. 1993, 28, 254.
31. Sastre, J.; Ibanez, M.D. Contact allergy to budesonide contained in a nasal spray. Allergy 1992, 47, 662.
32. Peris-Tortajada, A.; Giner, A.; Perez, C.; Hernandez, D.; Basomba, A. Contact allergy to topical budesonide. J. All. Clin. Immunol. 1991, 87, 598.
33. Faria, A.; Marote, J.; de Freitas, C. Contact allergy to budesonide in a nasal spray. Cont. Dermat. 1992, 27, 5.
34. Isaksson, M.; Bruze, M.; Wihl, J.A. Contact allergy to budesonide and perforation of the nasal septum. Cont. Dermat. 1997, 37, 133.
35. Iglesias Cadarso, A.; Diaz, C.; Laguna, J.J.; Hernandez Weigand, P. Allergic contact dermatomucositis to budesonide. J. All. Clin. Immunol. 1994, 94, 560.
36. Garcia Abujeta, J.L.; Fernandez, L.; Maquiera, E.; Picans, I.; Rodriguez, F.; Jerez, J. Contact allergy to budesonide in an oral spray. Cont. Dermat. 1995, 32, 253.
37. Gonzalo Garijo, M.A.; Bobadilla Gonzales, P. Cutaneous-mucosal allergic contact reaction due to topical corticosteroids. Allergy 1995, 50, 836.
38. Pirker, C.; Misic, P.; Frosch, P.J. Angioedema and dysphagia caused by contact allergy to inhaled budesonide. Cont. Dermat. 2003, 49, 79.
39. Held, E.; Ottevanger, V.; Petersen, V.S.; Weisman, K. Perioral dermatitis in children receiving budesonide inhalation therapy. Eur. J. Ped. Dermatol. 1995, 5, 144.
40. Auricchio, L.; Nino, M.; Suppa, F. Contact sensitivity to budesonide in a child. Cont. Dermat. 2000, 42, 359.
41. Cunha, A.P.; Mota, A.V.; Barros, M.A.; Bonito-Victor, A.; Resende, C. Corticosteroid contact allergy from a nasal spray in a child. Cont. Dermat. 2003, 49, 277.
42. Holmes, P.; Cowen, P. Spongiotic (eczematous-type) dermatitis after inhaled budesonide. Austr. NZ. J. Med. 1992, 22, 511.
43. Poon, E.; Fewings, J.M. Generalized eczematous reaction to budesonide in a nasal spray with cross reactivity to triamcinolone. Austr. J. Dermatol. 2001, 42, 37.
44. Capwell, S.; Reynold, S.; Shuttleworth, D.; Edwards, C.; Finlay, A.Y. Purpura and dermal thining associated with high dose inhaled corticosteroids. Br. Med. J. 1990, 300, 1551.
45. Isaksson, I.; Bruze, M. Allergic contact dermatitis in response to budesonide reactivated by inhalation of the allergen. J. Am. Acad. Dermatol. 2002, 46, 885.
46. Fuchs, T.; Uter, W.; Sprotte, U. Generalisierte urtikaria durch budesonid-verzogerte, IgE-vermittelte sofortreaktion? Allergologie 1991, 14, 238.
47. Lauerma, A.I.; Kistaala, R.; Makinen-Kiljiunen, S.; Haathela, T. Allergic skin reaction after inhalation of budesonide. Clin. Exp. All. 1993, 23, 233.
48. Dooms-Goossens, A. Clinical aspects of contact allergy to corticosteroids. Dermatology 1994, 189 (Suppl 2), 55.
49. Melamed, J.; Stone, B.; Beaucher, W.; Chelmsford, M.A. Anaphylaxis and flushing after the administration of intranasal fluticasone propionate (abstract). J. All. Clin. Immunol. 1996, 97, 350.
50. Wilkinson, S.M.; Beck, M.H. Fluticasone propionate and mometasone furoate have a low risk of contact sensitization. Cont. Dermat. 1996, 34, 366.
51. Venning, V.A. Fluticasone propionate sensitivity in a patient with contact allergy to multiple corticosteroids. Cont. Dermat. 1995, 33, 49.
52. Goossens, A.; Huygens, S.; Matura, M.; Degreef, H. Fluticasone propionate: a rare contact sensitizer. Eur. J. Dermatol. 2001, 11, 34.
53. Bos, J.D.; Meinerdi, M.M. The 500 Dalton rule for the skin penetration of chemical compounds and drugs. Exp. Dermatol. 2000, 9, 169.
54. Bundgaard, H. The possible implication of steroid-glyoxal degradation products in allergic reactions to corticosteroids. Arch. Pharm. Chem. Sci. Ed. 1980, 8, 90.
55. Wilkinson, S.M.; Jones, M.F. Corticosteroid usage and binding to arginine: determinants of corticosteroids hypersensitivity. Br. J. Dermatol. 1996, 135, 230.
56. Wilkinson, S.M.; English, J.S.C. Hydrocotisone sensitivity: clinical features of 59 cases. J. Am. Acad. Dermatol. 1992, 27, 687.
57. Wilkinson, S.M.; Cartwright, P.H.; English, J.S.C. The significance of tixocortol pivalate positive patch tests in leg ulcer patients. Cont. Dermat. 1990, 23, 121.
58. Corazza, M.; Mantovani, L.; Maraini, C.; Bacileri, S.; Virgili, A. Contact sensitization to corticosteroids: an increased risk in long term dermatoses. Eur. J. Dermatol. 2000, 10, 535.
59. Reitamo, S.; Lauerma, A.I.; Stubb, S.; Kayhko, K.; Visa, K.; Forstrom, L. Delayed hypersensitivity to topical corticosteroids. J. Am. Acad. Dermatol. 1986, 14, 589.
60. Knowles, S.R.; Uetrecht, J.; Shear, N.H. Idiosyncratic drug reactions: the reactive metabolite syndromes. Lancet 2000, 356, 1591.
61. Leanza, W.J.; Combere, J.P.; Rogers, E.F.; Pfister, K. Aldehydes derived from cortisone and hydrocortisone. J. Am. Chem. Soc. 1953, 76, 1694.
62. Dooms-Goossens, A. Is there a relation between contact allergy to alcohols and contact allergy to corticosteroids? Eur. J. Dermatol. 1993, 3, 713.
63. nd-Congress European Society of Contact Dermatitis. Octeber 1994, pg. 14.
64. Smith-Pease, C.K.; Basketter, D.A.; Patlewicz, G.Y. Contact allergy: the role of skin chemistry and metabolism. Clin. Exp. Dermatol. 2003, 28, 183.
65. Patel, L.; Clayton, P.E.; Addison, G.M.; Price, D.A.; David, T.J. Adrenal function following topical steroid treatment in children with atopic dermatitis. Br. J. Dermatol. 1995, 32, 955.
66. Morren, M.A.; Dooms-Goossens, A. Corticosteroid allergy in children: a potential complication of atopic eczema. Eur. J. Dermatol. 1994, 4, 109.
67. Schoenmakers, A.; Vermorken, A.; Degreef, H.; Dooms-Gossens, A. Corticosteroids or steroids allergy? Cont. Dermat. 1992, 26, 162.
68. Wilkinson, S.M.; English, J.C.S. Hydrocortisone sensitivity: a prospective study of the value of tixocortol pivalate and hydrocortisone acetate as patch test markers. Cont. Dermat. 1991, 25, 135.
69. Dooms-Goosssens, A. Identification of undected corticosteroid allergy. Cont. Dermat. 1988, 18, 125.
70. Degreef, H.; Dooms-Gooosens, A. The new corticosteroids: are they effective and safe? Dermatol. Clin. 1993, 11, 160.
71. Wolf, M.E.; Baxter, J.D.; Kollmann, P.A.; Lee, D.L.; Kuntz, I.D.; Bloom, E.; Matulich, D.T.; Morris, J. Nature of steroid-glucocorticoid receptor interactions: thermodynamic analysis of the binding reaction. Biochemistry 1978, 17, 3208.
72. Shroot, B.; Caron, J.C.; Ponec, M. Glucocorticoid specific binding: structure-activity relationship. Br. J. Dermatol. 1982, 107 (Suppl 23), 34.
73. Dooms-Goossens, A.; Morren, M. Results of routine patch testing with corticosteroid series in 2073 patients. Cont. Dermat. 1992, 26, 191.
74. Coopman, S.; Degreef, H.; Dooms-Goossens, A. Identification of cross-reaction patterns in allergic contact dermatitis to topical corticosteroids. Br. J. Dermatol. 1989, 121, 34.
75. Lepoittevin, J.P.; Drieghe, J.; Dooms-Goossens, A. Studies in patient with corticosteroid contact allergy. Understanding cross-reactivity. Arch. Dermatol. 1995, 131, 37.
76. Noda, H.; Matsunaga, K.; Noda, T.; Abe, M.; Ohtani, T.; Shimizu, Y.; Ashi, K.; Noriyasu, T.; Masutani, M.; Ueda, H. Contact sensitivity and cross-reactivity of budesonide. Cont. Dermat. 1993, 28, 215.
77. Dahlberg, E.; Thalen, A.; Brattsand, R. Correlation between chemical structure, receptor binding and biological activity of some novel highly active 16-17(acetal-substituted) glucocorticoids. Mol. Pharmacol. 1983, 25, 70.
78. Isaksson, M.; Bruze, M.; Lepoittevin, J.P.; Goossens, A. Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances. Am. J. Cont. Dermat. 2001, 12, 176.
79. Oh-i, T. Contact dermatitis due to topical steroids with conceivable cross-reactions between topical steroid preparations. J. Dermatol. 1996, 23, 208.
80. Wilkinson, S.M.; English, J.S.C. Hydrocortisone sensitivity. An investigation into the nature of the allergen. Cont. Dermat. 1991, 25, 181.
81. Wilkinson, S.M.; Hollis, S.; Beck, M.H. Reactions to other corticosteroids in patients with allergic contact dermatitis from hydrocortisone Br. J. Dermatol 1995, 132, 771.
82. th ed; McMillan Publishing: New York, 1985; 1489.
83. Wilkinson, S.M.; Hollis, S.; Beck, M. Reactions to other corticosteroids in patients with positive patch test reactions to budesonide. J. Am. Acad. Dermatol. 1995, 33, 968.
84. Kitano, Y. Hydrolisis of hydrocortisone-17-butyrrate-21-propionate by cultured human keratinocytes. Acta Dermatol. Venereol. 1986, 66, 102.
85. Stingeni, L.; Lisi, P. Contact allergy to prednicarbate: frequency of positive reactions in consecutively patch tested patients. Cont. Dermat. 1999, 40, 287.
86. Goossens, A.; Matura, M.; Degreef, H. Reactions to corticosteroids: some new aspects regarding cross-sensitivity. Cutis 2000, 65, 45.
87. Lauerma, A.I. Screening for corticosteroid contact hypersensitivity: comparison of tixocortol pivalate, hydrocortisone-17-butyrate and hydrocortisone. Cont. Dermat. 1991, 24, 130.
88. Balato, N.; Ayala, F.; Patruno, C.; Lembo, G.; Bianchi, B.; Foti, C.; Angelini, G. Mometasone furoate is an alternative for corticosteroid sensitive patients. Communication - Acts of Congress "Clinical Dermatology 2000." Singapore, 18-20 Giugno 1998.
89. Edsbacker, S.; Jonsson, S.; Lindberg, C.; Ryrfeldt, A.; Thalen, A. Methabolic pathways of the topical glucocorticoid budesonide in man. Drug Metabol. Dispos. 1983, 11, 596.
90. Ferguson, A.D.; Emerson, R.M.; English, J.S.C. Cross-reactivity patterns to budesonide. Cont. Dermat. 2002, 47, 340.
91. National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma. Bethesda, MD: National Heart, Lung and Blood Institute; National Institutes of Health, 1997. scaricabile da http://www.nhlbl.nih.gov.
92. Sommer, S.; Wilkinson, S.M.; English, J.S.C.; Gawkrodger, D.J.; Green, C.; King, C.M.; Powell, S.; Samson, J.R.; Shaw, S. Type IV hypersensitivity to betamethasone valerate and clobetasol propionate: results of a multicentre study. Br. J. Dermatol. 2002, 147, 269.
93. Stoeck, M.; Riedel, R.; Hochhaus, G.; Hafner, D.; Masso, J.M.; Schmidt. B.; Hatzelman, A.; Marx, D.; Bundscuh, D.S. In vitro and in vivo anti-inflammatory activity of the new glucocorticoid ciclesonide. J. Pharmacol. Exp. Ther. 2004, 309, 258.
94. Wilkinson, S.M.; Higgins, B.; Owen, S.; Mattey, D.; Woodcock, A. An assessment of steroid hypersensitivity in asthma. Respir. Med. 1997, 91, 233.
95. Isakkson, M.; Bruze, M.; Hornbland, Y.; Svenonius, E.; Wihl, J.A. Contact allergy to corticosteroids in asthma/rhinitis patients. Cont. Dermat. 1999, 40, 327.
96. Bennett, M.L.; Fountain, J.M.; McCarty, M.A.; Sherertz, E.F. Contact allergy to corticosteroids in patients using inhaled or intranasal corticosteroids for allergic rhinitis or asthma. Am. J. Cont. Dermat. 2001, 12, 196.
97. Emerson, R.M.; English, J.S.; Harrison, T.W.; Wisniewski, A.; Cooper, S.; Tattersfield, A.E. Do inhaled corticosteroids cause type-IV hypersensitivity reactions in asthma or chronic obstructive pulmonary disease (COPD)? Br. J. Dermatol. 2000, 143 (Suppl 57), 51.
98. Kilpio, K.; Hannuksela, M. Corticosteroid allergy in asthma. Allergy 2003, 58, 1135.
99. Dooms-Goossens, A.; Andersen, K.E.; Brandao, F.M.; Bruynzeel, D.; Burrows, D.; Camarsa, J.; Ducombs, G.; Frosch, P.; Hannuksela, M.; Lachapelle, J.M.; Lahti, A.; Mennè, T.; Wahlberg, J.E.; Wilkinson, D.J. Corticosteroid contact allergy: an EECDRG multicentre study. Cont. Dermat. 1996, 35, 44.
100. Farage, M.A.; Bjerke, D.L.; Mahony, C.; Blackburn, K.L.; Gerberick, G.F. Quantitative risk assessment for the induction of allergic contact dermatitis: uncertainty factors for mucosal exposure. Cont. Dermat. 2003, 49, 147.
101. Lauerma, A.; Rasanen, L.; Reinala, T.; Reitamo, S. Lgerhans cells but not monocytes are capable of antigen presentation in vitro in corticosteroid contact hypersensitivity. Br. J. Dermatol. 1990, 123, 705.
102. Faria, A.M.; Weiner, H.L. Oral tolerance: mechanisms and therapeutic applications. Adv. Immunol. 1999, 73, 164.
103. Kelly, H.W. Potential adverse effects of the inhaled corticosteroids. J. All. Clin. Immunol. 2003, 112, 477.
104. Whitemore, S.E. Delayed systemic allergic reactions to corticosteroids. Cont. Dermat. 1995, 32, 195.
105. Demitsu, T.; Kosuge, A.; Yamada, T.; Usui, K.; Katayama, H.; Yaoita, H. Acute generalized exanthematous pustolosis induced by dexamethasone injection. Dermatology 1996, 193, 58.
106. Heeringa, M.; Zweers, P.; deMan, R.A.; deGroot, H. Anaphylactic like reaction associated with oral budesonide. Br. Med. J. 2000, 321, 927.
107. Polosa, R.; Prosperini, G.; Pintaldi, L.; Rey, J.P.; Colombrita, R. Anaphylaxis after prednisone. Allergy 1998, 53, 331.
108. Bircher, A.J.; Levy, F.; Langauer, S.; Lepoittevin, J.P. Contact allergy to topical corticosteroids and systemic contact dermatitis from prednisolone with tolerance of triamcinolone. Acta Dermatol. Venereol. 1995, 75, 495.
109. Crijns, M.B.; Nater, J.P.; van Oosten, F.; van der Waalk, P.G. Vasoconstrictor and the anti-inflammatory effects of seven corticosteroids. Cont. Dermat. 1984, 11, 111.
110. Wilkinson, S.M.; Beck, H.M. Corticosteroids contact hypersensitivity: what vehicle and concentration? Cont. Dermat. 1996, 34, 308.
111. Isaksson, M.; Bruze, M.; Leipottevin, J.P. Patch testing with budesonide in serial dilutions: the significance of dose, occlusion time and reading time. Cont. Dermat. 1999, 40, 31.