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Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances

Isaksson, M; Bruze, Magnus LU ; Lepoittevin, Jean-Pierre and Goossens, An (2001) In American Journal of Contact Dermatitis 12(3). p.170-176
Abstract
BACKGROUND: Budesonide, a marker for corticosteroid allergy, is a 1:1 mixture of 2 diastereomers, the R and S, present in all commercial formulations. Budesonide is said to cross-react with group B substances through the R and S diastereomer and some group D substances only through the S diastereomer. OBJECTIVE: To investigate the cross-reactivity pattern between the R and S diastereomers and 4 potentially cross-reacting substances, 2 from group B and 2 from group D. METHODS: By patch testing 10 patients hypersensitive to budesonide with a serial dilution of budesonide, the R and S diastereomer, triamcinolone acetonide, amcinonide, prednicarbate, and hydrocortisone-17-butyrate. RESULTS: Nine of 10 patients reacted to budesonide and the S... (More)
BACKGROUND: Budesonide, a marker for corticosteroid allergy, is a 1:1 mixture of 2 diastereomers, the R and S, present in all commercial formulations. Budesonide is said to cross-react with group B substances through the R and S diastereomer and some group D substances only through the S diastereomer. OBJECTIVE: To investigate the cross-reactivity pattern between the R and S diastereomers and 4 potentially cross-reacting substances, 2 from group B and 2 from group D. METHODS: By patch testing 10 patients hypersensitive to budesonide with a serial dilution of budesonide, the R and S diastereomer, triamcinolone acetonide, amcinonide, prednicarbate, and hydrocortisone-17-butyrate. RESULTS: Nine of 10 patients reacted to budesonide and the S diastereomer. Seven of 9 to the R diastereomer. Each of the 9 patients with S diastereomer allergy reacted to the group B and/or group D substances. Five patients reacted to triamcinolone acetonide, not to 1.0% but only to 0.0010% and 0.00010%. CONCLUSION: The R and S diastereomers can induce positive patch test reactions in budesonide-hypersensitive individuals. The potential of budesonide to cross-react with substances from group B and D might be explained by the presence of the 2 diastereomers. When patch testing with triamcinolone acetonide, much lower concentrations than recommended should be used. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Contact Dermatitis
volume
12
issue
3
pages
170 - 176
publisher
BC Decker
external identifiers
  • pmid:11526524
  • scopus:0034827351
ISSN
1046-199X
DOI
10.1053/ajcd.2001.20553
language
English
LU publication?
yes
id
b5edbcb0-2328-4276-92ab-d00aea40bf4d (old id 1121506)
date added to LUP
2008-06-30 16:05:33
date last changed
2018-01-07 09:12:52
@article{b5edbcb0-2328-4276-92ab-d00aea40bf4d,
  abstract     = {BACKGROUND: Budesonide, a marker for corticosteroid allergy, is a 1:1 mixture of 2 diastereomers, the R and S, present in all commercial formulations. Budesonide is said to cross-react with group B substances through the R and S diastereomer and some group D substances only through the S diastereomer. OBJECTIVE: To investigate the cross-reactivity pattern between the R and S diastereomers and 4 potentially cross-reacting substances, 2 from group B and 2 from group D. METHODS: By patch testing 10 patients hypersensitive to budesonide with a serial dilution of budesonide, the R and S diastereomer, triamcinolone acetonide, amcinonide, prednicarbate, and hydrocortisone-17-butyrate. RESULTS: Nine of 10 patients reacted to budesonide and the S diastereomer. Seven of 9 to the R diastereomer. Each of the 9 patients with S diastereomer allergy reacted to the group B and/or group D substances. Five patients reacted to triamcinolone acetonide, not to 1.0% but only to 0.0010% and 0.00010%. CONCLUSION: The R and S diastereomers can induce positive patch test reactions in budesonide-hypersensitive individuals. The potential of budesonide to cross-react with substances from group B and D might be explained by the presence of the 2 diastereomers. When patch testing with triamcinolone acetonide, much lower concentrations than recommended should be used.},
  author       = {Isaksson, M and Bruze, Magnus and Lepoittevin, Jean-Pierre and Goossens, An},
  issn         = {1046-199X},
  language     = {eng},
  number       = {3},
  pages        = {170--176},
  publisher    = {BC Decker},
  series       = {American Journal of Contact Dermatitis},
  title        = {Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances},
  url          = {http://dx.doi.org/10.1053/ajcd.2001.20553},
  volume       = {12},
  year         = {2001},
}