Deflazacort hypersensitivity: a difficult‐to‐manage case of systemic allergic dermatitis and literature review

Systemic allergic dermatitis presenting as acute generalized exanthematous pustulosis due to betamethasone sodium phosphate

“…To our knowledge, this is the first report of AGEP caused by betamethasone sodium phosphate. To date, 6 cases of AGEP due to systemic corticosteroids have been described (Table S1): in 4 patients due to corticosteroids belonging to Group A and Cluster 1, in one patient to Group C and Cluster 3, and in one patient to deflazacort, which is not included in any group or cluster because of its 16α‐17α‐2 methyloxazolinic ring . Among these patients, only one experienced previous contact sensitization to prednisolone acetate cream; as in our case, this data is suggestive of systemic allergic dermatitis to prednisolone presenting as AGEP.…”

Cross‐reactions to systemic corticosteroids in patients contact sensitized to budesonide

“…3 Patients are difficult to manage, owing to the high frequency of cross-reactions not only among topical 4 but also systemic corticosteroids (SCSs). 5 In fact, patients previously contact sensitized to budesonide are at risk of systemic allergy caused by SCS, 6 as described for patients with hydrocortisone hypersensitivity. 7 Herein we present a study on patch tests with a series of SCS in patients with contact allergy to budesonide.…”

Deflazacort-Induced Erythema Multiforme Exudativum Successfully Treated With a Single Dose of Etanercept

“…The corticosteroids most frequently involved in delayed reactions are dexamethasone, betamethasone, and triamcinolone acetonide [2]. Reports of hypersensitivity to deflazacort are rare and include maculopapular rash, acute exanthematous pustulosis, and toxic epidermal necrolysis (TEN) [3][4][5]. No cases of deflazacort-induced erythema multiforme exudativum (EME) have been reported.…”

“…We report the case of a patient who developed a delayed reaction to deflazacort in which 2 skin biopsies confirmed the diagnosis of EME. Previous reports of delayed hypersensitivity to deflazacort included maculopapular rash, TEN, and acute generalized exanthematous pustulosis [3][4][5]. The efficacy of TNF blockers in the treatment of TEN has been demonstrated in recent years [6][7][8][9][10], although no cases of EME successfully treated with this drug have been reported to date.…”