Urticaria to methylprednisolone sodium hemisuccinate (original) (raw)
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Acute Urticaria Induced by Oral Methylprednisolone
Allergy, Asthma and Immunology Research, 2011
The patient was followed regularly with a maintenance medication regimen that included a combination of an inhaler and a leukotriene receptor antagonist. The patient had typically used a systematic steroid for several days for relief of asthma exacerbations; this regimen had been well-tolerated and proven effective in improving symptoms. More recently, the patient experienced worsening of dyspnea and wheezing, and was diagnosed with asthma exacerbation due to an upper respiratory infection; therefore, a low dose (8 mg) of oral methylprednisolone was prescribed. Acute, whole body generalized urticaria developed after ingesting this medication. An oral provocation test was performed to confirm the casual relationship between the urticaria and cortisosteroids. No responses were observed following an oral provocation test to deflazacort, which is an alternative corticosteroid. However, 20 minutes after taking oral methylprednisolone (4 mg), generalized urticaria developed (Figure). The diagnosis was acute generalized urticaria caused by oral methylprednisolone. The symptom-relieving therapy was changed from the use of
Effects of local corticosteroids on acute experimental urticaria
European journal of dermatology : EJD
Corticosteroids are often used in the treatment of acute or chronic urticaria. However, their effects on mastocyte activation as well as on the histamine-induced dermal oedema remain poorly investigated. The aim of the present study was to investigate the effects of corticosteroids (CS) on the development of acute experimental urticaria induced by prick-tests with histamine and codeine. This experimental model corresponds to the common form of urticaria. CS were administered at the site of the histamine and codeine prick tests in order to test for a direct effect on the development of acute urticaria. Two types of experiments were performed: 1) after a 48-hour period of topical CS application on the forearm, 7 healthy volunteers were skin prick-tested with histamine and codeine simultaneously in duplicate, one series in the pretreated area and the other in a non-treated area. 2) six other volunteers were prick-tested with histamine and codeine on their forearm, in duplicate. Immedia...
Allergy and Asthma Proceedings, 2016
Background: Treatments for patients with chronic idiopathic urticaria (CIU)-chronic spontaneous urticaria (CSU) who were unresponsive to antihistamines include oral corticosteroids (OCS). Risks of OCS-related side effects in these patients have not been described quantitatively. Objective: To investigate the relationship between OCS use and the risk of developing side effects possibly attributable to OCS and associated health care costs in privately insured patients with CIU/CSU. Methods: This retrospective cohort study analyzed a commercial claims data base from January 1, 2008, to December 31, 2012. Patients with CIU/CSU were identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes via a validated algorithm. Possible OCS-related side effects included the following: diabetes mellitus, hypertension, lipid disorders, cataracts, depression or mania, osteoporosis or fractures, and infectious diseases. A time-dependent Cox regression (adjusted for age, sex, Charlson Comorbidity Index, and immunomodulator use) was used to separately model cumulative oral prednisone-equivalent exposure and the risk of side effects. Incremental total adjusted health care costs were compared in patients with versus patients without possible OCS-related side effects. Results: Among 12,647 patients with CIU/CSU, 55.4% used OCS. An additional 1 g of prednisone-equivalent exposure was associated with a 7% increase in the likelihood of developing a possible side effect (hazard ratio, 1.
Reactions to other corticosteroids in patients with allergic contact dermatitis from hydrocortisone
British Journal of Dermatology, 2006
It has been proposed that corticosteroid cross-reactions occur more frequently within structurally well-defined groups. To test this hypothesis we have compared the patch-test reactions to other corticosteroids in 96 patients allergic to hydrocortisone. We found that our data did not agree with the previously proposed classification. The presence ofa substitution at the C^ or Cy position was the most important factor in determining whether a patient would be allergic to another corticosteroid. This information should facilitate the choice of an alternative corticosteroid in patients allergic to hydrocortisone. if facilities for patch testing to other corticosteroids are not available.
Study Of Corticosteroid Use In Dermatological Conditions With Adverse Effect Profile
IOSR Journals , 2019
Introduction: The ultimate goal in dermatological therapy is to use the safest and least number of drugs in order to obtain the best possible effect in the shortest period at reasonable cost. One step to achieve this is to monitor, evaluate and therapeutically analyze the prescribing pattern of dermatological drugs. Such analysis will not only improve the standards of medical treatment at all levels in the health system, but will also help in the identification of problems related to drug use such as polypharmacy,drug-drug interaction and adverse drug reactions. The ultimate outcome of the dermatological prescription analysis will be a message to the prescribing physician to achieve rational, cost-effective medical care. Aim. Evaluation of adverse effects of corticosteroids on systemic and topical administration of steroids in dermatological conditions-by monitoring prescriptions and to find the percentage incidence of adverse effects on topical, oral and both and in combination with other routes of administration. Methods: After obtaining approval from the IEC and valid informed consent, the participants were recruited into the study. This cross-sectional descriptive study was conducted in Andhra Medical College, Vishakhapatnam, Andhra Pradesh, India for 200 patients/ Five hundred prescriptions were randomly collected from the drug-dispensing counter and analyzed. The prescriptions were written by dermatologists. Data will be analyzed with respective to side effect profile. of gender wise age wise incidence will be noted. Results: Total of 200 patients got enrolled in this study, out of which 127 were female and 63 were male. Mean (±SD) age of the patients was 40.5 years (±15.0) as the age increases the incidence of adverse effects increases. Majority of the patients (n=140(70%)) have used topical corticosteroids, 60 (30%) have used corticosteroids by systemic route. The ADE through other systemic routes were also considered along with topical corticosteroids Conclusion: prescriptions were monitored for adverse effects of topical corticosteroids and steroids on systemic therapy and found that various adverse effects on topical administration are equally carries the risk of ADR The study showed that there is increase in incidence of ADRs with corticosteroids as age advances. The incidence of ADRs s also more in females when compared with males.
Topical corticosteroids in dermatology
Indian journal of dermatology, venereology and leprology, 2016
Since their introduction, topical corticosteroids have become indispensable in the treatment of various dermatoses. Hydrocortisone was the first compound; modifications in the basic structure generated in vivo activity and thus different topically active compounds were discovered. Apart from the Stoughton vasoconstrictor assay, various other methods are used for potency assessment of topical corticosteroids. Topical corticosteroides are classified based upon potency and action of these molecules. Mechanism of action at the cellular level and indications of topical corticosteroid use have been discussed. Various adverse effects often occur as an extension of their activity combined with inappropriate usage. Tachyphylaxis and contact allergy are potential problems in clinical practice. Newer compounds with improved risk-benefit ratio are available.
Journal of Evidence Based Medicine and Healthcare, 2020
BACKGROUND Allergic rhinitis is a fairly common condition. A large number of patients of allergic rhinitis are usually found in daily ENT practice. Symptoms of allergic rhinitis are still a major problem, which can affect day to day activities of an individual. Intranasal corticosteroid has potent anti-inflammatory actions and is believed to exert its beneficial effects by inhibiting several types of cells and chemicals involved in immune and inflammatory responses. Present study determines the efficacy of intra nasal corticosteroid over placebo in patients of allergic rhinitis. METHODS A single blinded non-randomised trial was conducted among patients attending allergy clinic of ENT out-patient department of a Tertiary Medical College & Hospital of West Bengal, India from March 2008 to May 2008. Two groups of patients were selected from the total sample size of 100 patients by alternate sampling technique. One group (Gr-F) was treated by intranasal corticosteroid (fluticasone nasal...