Danilo Assalve

Erythema-multiforme-like contact dermatitis from budesonide

Case Reports Case no. 1 A 19-year-old non-atopic girl with acne, with allergic contact dermatitis of the face and hands from benzoyl peroxide, was treated with 0.1% budesonide ointment (Preferid® lipocrema) 2Xdaily. After 5 days, she showed a fresh outbreak oflesions and an erythema-multiformelike eruption on the hands, forearms and face. Patch and prick tests with the allergens listed in Table 1 showed delayed-type positive reactions to budesonide and triamicinolone acetonide. After suspension of the topical corticosteroid, the dermatitis quickly improved without further treatment.

Skin tests in the diagnosis of eruptions caused by betalactams

The aetiologic evaluation of adverse cutaneous reactions to penicillins is still not an easy problem to solve. Skin testing is usually earned out intradermally with benzylpenicilloyl polylysine (BPO‐PPL) and minor determinant mixture (MDM), but these are often unsuitable for the detection of sensitivity to betalactam antibiotics. 101 selected subjects, with different cutaneous reactions to betalactams and with a clinical history of positive challenge, were skin tested (patch lest, prick test, intradermal test) with a standard betalactam series (amoxycillin, sodium penicillin G, ampicillin, bacampicillin, aztreonam, ceftriazone, BPO‐PPL, MDM). 1 or more positive reactions to skin tests, mainly to intradermal tests, were observed in 47.5% of the subjects studied, especially in those with maculopapular eruptions, urticaria/angioedema and drug reactions caused by ampicillin and amoxycillin. Cross‐sensitivity was demonstrated in 22.8% of cases and was due almost solely to the semi synthetic penicillin. Finally, to increase the yield in detecting positive patients, it is necessary that ampicillin and amoxycillin be tested in addition to major and minor determinants.

Occupational allergic contact dermatitis with secondary spreading from vitamin k3 sodium bisulphite in a pig farmer.

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