CONTACT HYPERSENSITIVITY TO TIXOCORTOL PIVALATE

Background: Tixocortol pivalate is an established marker to topical co rticosteroid allergy. The prevalence of tixocortol pivalate hypersensi tivity is well established in Europe, where exposure to this corticost eroid as a therapeutic agent varies. In the United States, tixocortol pivalate is not commercially available and the prevalence of hypersens itivity to it is unknown. Objective: We investigated the prevalence of tixocortol pivalate hypersensitivity in our patch-tested population. We further characterized these patients by clinical background, other contact allergens, and the reactivity to other corticosteroids. Method s: Tixocortol pivalate has been incorporated in our standard 1-52 patc h test series since November 1992. We reviewed the histories and patch test results in all patients tested with the standard 1-52 series fro m November 1992 to December 1996. Results: Of 1536 patch-tested patien ts, 45 had hypersensitivity to tixocortol pivalate. Dermatitis involvi ng the face was the most common (14 patients). Of the 45 patients, 40 had another allergen identified on patch testing. Eighteen patients un derwent further patch testing to an extended corticosteroid panel, and 14 had sensitivity to another steroid agent. Conclusion: The 2.9% pre valence of tixocortol pivalate hypersensitivity in our patch test popu lation is within the range reported in Europe. Patients with tixocorto l pivalate hypersensitivity tend to have other contact allergens on pa tch testing. Predisposing factors to tixocortol pivalate hypersensitiv ity include facial dermatitis and sensitivity to other contact allerge ns.