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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 63-year-old man presented with severe scaly erythema on his scalp, face, and neck, and erythema on his trunk, arms, and legs after having been treated with clobetasol propionate ointment and lanoconazole cream. Patch tests were positive to clobetasol 0.05% ointment ‘as is’, clobetasol propionate 0.05% pet., lanoconazole cream ‘as is’ and lanoconazole 0.1% and 1% pet. (17). A 74-year-old-man, with eczema of the external auditory meatus for 6 months, was referred because of worsening of the otitis externa one day after applying clobetasol cream, together with spread to the thorax and axilla. He had also previously suffered a generalized erythema some hours after an intra-articular injection of paramethasone. The patient had a history of recurrent episodes of eczema in the axillae, flexural folds of the arm and the inguinal folds (highly suggestive of systemic contact dermatitis). Patch tests were positive to clobetasol propionate (CP) 0.05% cream, CP 1% pet., paramethasone acetate 2 mg/ml injection fluid and many other corticosteroids (39).
Systemic Contact Dermatitis
Published in Kirsti Kauppinen, Kristiina Alanko, Matti Hannuksela, Howard Maibach, Skin Reactions to Drugs, 2020
SCD reactions to corticosteroids have gained much attention in recent years. Most reports deal with single cases, and only in sporadic cases challenge tests have been routinely performed (see Reference 52). In a 69-year-old female patient who had experienced five episodes of systemic reactions from intravenous corticosteroids given for her asthma, intradermal tests with hydrocortisone phosphate, 1 and 10 mg/ml, and with methylprednisolone, 0.4 and 4.0 mg/ml, produced in 6 hours a local and then a systemic pruritic erythematous reaction.44 A 55-year-old female patient with SCD from methylprednisolone tolerated well paramethasone and fluocortolone in therapeutic doses.41 Reappearance of positive PTs after a peroral challenge with 100 mg of hydrocortisone was noticed in two patients with positive PTs to hydrocortisone and hydrocortisone-17-butyrate.9 In the same study, 250 mg of hydrocortisone produced erythematous and edematous rash in two other patients with both hydrocortisone and hydrocortisone-17-butyrate allergy. Two patients with negative PT to hydrocortisone and positive PT to hydrocortisone-17-butyrate did not react to 250 mg of peroral hydrocortisone.9
Perioperative steroids
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Manual of Neuroanesthesia, 2017
Steroids are the hormones produced by the adrenal cortex.1 Among the steroids that are produced by the adrenal cortex, glucocorticoids are used for treatment of a wide range of diseases and in neuroanesthesia applications. The glucocorticoids that are available and in use can be divided into three groups: Short acting: cortisol, cortisone, prednisone, prednisolone, and methylprednisoloneIntermediate acting: triamcinolone, paramethasone, and fluprednisoloneLong acting: betamethasone and dexamethasone
Risk factors for fractures following liver transplantation: a population-based cohort study
Published in Annals of Medicine, 2023
Jei-Wen Chang, Hui-Hsin Yang, Niang-Cheng Lin, Fang-Cheng Kuo, Tzu-Ching Lin, Hsin-Lin Tsai
The dosage of systemic glucocorticoids including that prescribed orally at outpatient visits and that taken orally or intravenously during inpatient treatment were calculated until the date of fracture or the study end date. The glucocorticoids included betamethasone (Anatomical Therapeutic Chemical [ATC] code H02AB01), dexamethasone (ATC code H02AB02), methylprednisolone (ATC code H02AB04), paramethasone (ATC code H02AB05), prednisolone (ATC code H02AB06), triamcinolone (ATC code H02AB08), hydrocortisone (ATC code H02AB09), and cortisone (ATC code H02AB10). All glucocorticoid prescriptions were converted to prednisolone equivalents. The mean daily prednisolone dosage was classified into four groups by quartile: 0–1.61 mg/day, >1.61–3.78 mg/day, >3.78–9.18 mg/day, and >9.18 mg/day. Data on other immunosuppressive drugs used to prevent rejection including tacrolimus (ATC code L04AD02), cyclosporine (ATC code L04AD01), mycophenolate mofetil/mycophenolic acid (ATC code L04AA06) and sirolimus (ATC code L04AA10)/everolimus (ATC code L04AA18) that were prescribed within the follow-up period were extracted for analysis. Data on the drugs most often used in the treatment of osteoporosis including bisphosphonate (ATC codes M05BAxx and M05BBxx), calcium (ATC codes A12AAxx and V03AE07), vitamin D (ATC code A11CCxx) and calcium with vitamin D (ATC code A12AXxx) supplements were also recorded.
Salicylate toxicity after undetectable serum salicylate concentration: a retrospective cohort study
Published in Clinical Toxicology, 2019
Michael J Moss, J Ashton Fisher, Tara A Kenny, Allison C Palmer, John A Thompson, Hannah Wolfer, Robert G Hendrickson
Several cases of salicylate toxicity with initially undetectable [ASA] have been reported. Kaufman reported an 18-month female who ingested 10 to 15 tablets of a delayed release aspirin, paramethasone, and propoxyphene product. Serum [ASA] was undetectable at 4 h but at 16 h a repeat urine ferric chloride test was positive and [ASA] was 33 mg/dL [8]. Wortzman described a 22-year-old male who ingested 88 tabs of 325 mg delayed release aspirin. [ASA] at 1 and 3 h were undetectable [11]. At 7 h [ASA] was 13.3 mg/dL and peaked at 35.8 mg/dL at 24 h after ingestion. Elko reported a 12-year-old female who ingested an unknown quantity of enteric coated aspirin 325 mg [6]. [ASA] was <2.8 mg/dL at 2 h and peaked at 34 mg/dL 20 h after ingestion. Herres reported a 53-year-old male who ingested 200 tablets of 325 mg aspirin [7]. Approximately 45 min after ingestion [ASA] was undetectable but was elevated to 33 mg/dL at 3 h. He was transferred to a psychiatric ward and ultimately died 20 h after ingestion with a peak [ASA] of 128 mg/dL. Grandey reported 13 cases of initial [ASA] that were <10 mg/dL but not necessarily undetectable [12]. They do specifically report one patient with an undetectable [ASA] that later peaked at 54.8 mg/dL though further detail is not available beyond an abstract. These authors hypothesized several factors that could contribute to delayed detection and absorption of salicylates such as enteric coated or delayed release preparations, ingestion of agents delaying gastric emptying, pylorospasm, pharmacobezoar formation, or repeated ingestions while under medical care and after initial blood draws.