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2.
Ann Dermatol Venereol ; 132(2): 143-6, 2005 Feb.
Artigo em Francês | MEDLINE | ID: mdl-15798566

RESUMO

BACKGROUND: Inhaled corticosteroids are widely used in allergic asthma and rhinitis. They are most often used alone or sometimes in association. Allergic side-effects of inhaled corticosteroids are less frequent than those of topical corticosteroids. We report a case of a connubial dermatitis to a budesonide spray. OBSERVATION: A 3-year old boy was treated for asthma by budesonide (Pulmicort) and terbutaline (Bricanyl) aerosols with an inhalation chamber (Babyhaler). From the fourth day of treatment onwards, his mother had swollen and itchy lesions on the face with conjunctivitis several hours after the administration of the corticosteroids using the inhalation chamber. The last eruptions were marked by extensive lesions. The patient reported a worsening of her eruption when she was treated with a desonide cream (Tridesonit). Prick-tests conducted later on confirmed the contact allergy to budesonide and Pulmicort spray. They were also positive for Tridesonit cream and triamcinolone acetonide. Repeated open application tests with a 17-butyrate hydrocortisone cream (Locoid) for three weeks remainded negative. DISCUSSION: Our observation is original: allergic contact dermatitis to inhaled corticosteroids is rare, the clinical presentation mimicked angioedema although it was a delayed-type hypersensitivity, hypersensitivity was limited to group B corticosteroids and it was in fact a connubial contact dermatitis.


Assuntos
Broncodilatadores/efeitos adversos , Broncodilatadores/uso terapêutico , Budesonida/efeitos adversos , Budesonida/uso terapêutico , Dermatite Alérgica de Contato/etiologia , Terbutalina/efeitos adversos , Terbutalina/uso terapêutico , Administração por Inalação , Angioedema/diagnóstico , Asma/tratamento farmacológico , Broncodilatadores/administração & dosagem , Budesonida/administração & dosagem , Pré-Escolar , Dermatite Alérgica de Contato/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Nebulizadores e Vaporizadores , Terbutalina/administração & dosagem
3.
Allerg Immunol (Paris) ; 19(3): 97-103, 1987 Mar.
Artigo em Francês | MEDLINE | ID: mdl-3331268

RESUMO

Sudden severe life threatening attack (SSA) may occasionally develop in some patients who have had until that event a mild asthma without detectable baseline airway obstruction. Airway responsiveness (AR) measurement could be a useful mean to characterize or identify them. No data exist regarding the baseline non specific AR of such patients. We studied 5 patients having had a SSA during their past few weeks. Methacholine (MCH) challenges were performed only when standard pulmonary function tests were close to normal (FEV1 greater than or equal to 80% pred.); the patients were off medication at the time of MCH challenges. 3 to 8 evaluations were performed over a time span of 4 to 24 months. The level of AR ranged from moderately increased (PC20 = 24 mg/ml). Mean PC20 was 7,8 mg/ml. This level of AR did not differ significantly from that found in a population of 67 mild asthmatics who also were evaluated in the absence of baseline bronchial obstruction and were off medication (PC20 = 5,5mg/ml). In any individual asthmatic having sustained SSA, AR was strikingly stable. However in two patients we detected a marked decrease in PC20 which was followed within 2 weeks by a SSA. We conclude that: 1. Asthmatics who have had SSA do not demonstrate particularly AR, which is not related to the severity of their asthma. 2. Baseline AR is usually stable. 3. The measurement of AR in these patients is not very useful, specially for substantiating medication needs. 4. A marked increase in AR can be observed before SSA.


Assuntos
Asma/fisiopatologia , Testes de Provocação Brônquica , Morte Súbita/etiologia , Estado Asmático/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Cloreto de Metacolina , Compostos de Metacolina , Pessoa de Meia-Idade , Fatores de Risco , Estado Asmático/mortalidade
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