Effect of coadministration of corticosteroids on the development of contact sensitization

• Published in: Journal of the American Academy of Dermatology Vol. 35; no. 1; pp. 27 - 31
• Main Authors: Amkraut, Alfred A., Jordan, William P., Taskovich, Lina
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.1996; Elsevier
• Subjects: Administration, Cutaneous; Adult; Allergic diseases; Anti-Allergic Agents - administration & dosage; Anti-Allergic Agents - adverse effects; Benzoyl Peroxide - administration & dosage; Benzoyl Peroxide - adverse effects; Biological and medical sciences; Chlorpheniramine - administration & dosage; Chlorpheniramine - adverse effects; Dermatitis, Contact - etiology; Dermatitis, Contact - prevention & control; Drug Combinations; Feasibility Studies; Female; Humans; Hydrocortisone - administration & dosage; Hydrocortisone - pharmacokinetics; Hydrocortisone - therapeutic use; Immune Tolerance; Immunization; Immunopathology; Keratolytic Agents - administration & dosage; Keratolytic Agents - adverse effects; Medical sciences; Patient Compliance; Skin - immunology; Skin Absorption; Skin allergic diseases. Stinging insect allergies; Human; Delivery system; Corticosteroid; Skin disease; Drug combination; Treatment efficiency; Antiinflammatory agent; Percutaneous route; Immunomodulator; Prevention; Chemotherapy; Treatment; Contact dermatitis
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/S0190-9622(96)90491-0

Background: Transdermal administration of drugs can increase patient compliance and reduce side effects, but it can also cause contact sensitization. Corticosteroids frequently are used to suppress the local immune response; however, their use as a pretreatment for transdermal system application sites is not practical. Objective: Our purpose was to determine the feasibility of suppressing contact sensitization by delivering a corticosteroid with the transdermal delivery systems. Methods: Materials were applied continuously for 3 weeks to the same (protocol SS) or different (protocol AS) skin sites. Skin flux and appearance of sensitization were determined. Results: Coadministration of hydrocortisone reduced the incidence of sensitization by d-chlorpheniramine and benzoyl peroxide from 45% to 7.5% and from 20% to 2.3%, respectively, under protocol SS. Under protocol AS, sensitization by d-chlorpheniramine was reduced from 15% to 1%. Frequent exposure to the sensitizer plus corticosteroid induced tolerance to the sensitizer. Conclusion: Sensitization by moderately immunogenic drugs after any length of exposure may be reduced to acceptable levels by the coadministration of hydrocortisone.