Title: Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances
Authors: Isaksson, M ×
Bruze, M
Lepoittevin, J P
Goossens, An #
Issue Date: Sep-2001
Series Title: American journal of contact dermatitis : official journal of the American Contact Dermatitis Society vol:12 issue:3 pages:170-6
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.
ISSN: 1046-199X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Dermatology
Laboratory of Dermatoimmunology (+)
× corresponding author
# (joint) last author

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