PATCH TESTING

(1) Patch testing - delay after parenteral steroids
-------------------------------------------------------------
	
	
	-----------------------------------------------
	PATCH TESTING - DELAY AFTER PARENTERAL STEROIDS
	-----------------------------------------------


How soon after Kenalog I.M. may one patchtest.  We are not of one opinion
here in Madtown.     

Diane Thaler MD
---------------

I would wait three plus weeks, depending on dose, mainly because I do not 
know any better. Check with pharmacy on kinetics of IM triamcinolone.

Jerry Eisner MD
---------------


Unfortunately, there is no one opinion. It probably depends upon a)how
allergic the patient is to the substance; b) the dose of kenalog; and, c)
whether the steroid vehicle was aqueous or w/  sorbitol for slow
release. With the above in mind, my bias would be to wait 3 wks. to be
absolutely sure you're not going to miss a relevant reaction. However, if
you used a purely aqueous vehicle w/ nothing to slow the absorption of
the steroid you may be able to get accurate results after 1 wk.;
however, "may" is the operative word.
Wish I could be more definite. Good luck!

Don Belsito MD
--------------


I don't know the exact answer, but PPD tests remain positive after two weeks
of 40mg/prednisone.  I wish I could cite the ref. but its a very old one 
that I read years ago.

Guy Webster MD
--------------


Was the TB skin test applied before or after the prednisone
was initiated? I think it might make a difference?  

Diane Thaler MD
---------------