A Case of Delayed-type Reaction Caused by Intravenous Administration of Prednisolone Sodium Succinate : Patch Test of Topical Steroid Preparations as a Useful Diagnostic Tool

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  • 副腎皮質ステロイド外用剤によるパッチテストが診断に有用であった 水溶性プレドニン<sup>®</sup>による薬疹の 1 例
  • 症例 副腎皮質ステロイド外用剤によるパッチテストが診断に有用であった水溶性プレドニンによる薬疹の1例
  • ショウレイ フクジン ヒシツ ステロイド ガイヨウザイ ニ ヨル パッチテスト ガ シンダン ニ ユウヨウ デ アッタ スイヨウセイ プレドニン ニ ヨル ヤクシン ノ 1レイ

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A 45-year-old woman with sudden deafness was administered prednisolone sodium succinate (PSL-SS) at 60 mg/day and developed itchy disseminated erythematous eruptions on her trunk and both axillas after 3 days. We suggested a drug eruption caused by PSL-SS and started a treatment with betamethasone (BMZ) at 4 mg/day orally instead. Her skin symptoms improved within a week, but her deafness continues even now. A histologic examination of the erythema on her abdomen revealed a liquefaction degeneration of the epidermal-dermal junction and a moderate perivascular lymphocytic and eosinophilic infiltration in the dermis. A patch test showed positive reactions to prednisolone tablet, prednisolone sodium acetate ointment, and PSL-SS. Methylprednisolone tablet and ointment also showed positive reactions. BMZ ointments showed negative reactions. We diagnosed that she had a delayed-type reaction caused by prednisolone and a cross-reaction to methylprednisolone. We, dermatologists have to know not only the drug reactions caused by corticosteroids but also the classification of synthetic corticosteroids. To the best of our knowledge, the determination of a corticosteroid preparation that can be safely administered to patients via the patch testing of topical steroid preparations is easy and has a high positive rate.

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