Angry back - Altmeyers Encyclopedia - Department Dermatology

Synonym(s)

Epicutaneous reaction false positive; Excited skin syndrome; false positive epicutaneous reaction

Definition
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Occurrence of false positive epicutaneous test reactions due to increased sensitivity, e.g. epicutaneous testing in florid disease. The substances triggering these non-specific test reactions have no clinical relevance.

External therapy
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Glucocorticoid externa in indifferent bases such as 0.5-1.0% hydrocortisone ointment, 0.1% hydrocortisone butyrate cream (e.g. Alfason), 0.1% betamethasone ointment (e.g. Betagalen, Betnesol), 0.25% prednicarbate ointment(e.g. Dermatop), mometasone furoate ointment(e.g. Ecural).

Internal therapy
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If necessary, temporary adjustment to an oral antihistamine, such as levocetirizine (e.g. Xusal) 1 tablet/day or desloratadine (e.g. Aerius) 1 tablet/day. Increased effect is seen with i.v. administration, e.g. with dimetindene (e.g. Fenistil) 4-8 mg/day i.v.

In the case of extensive findings, short-term internal use of glucocorticoids in low doses such as prednisolone (e.g. Decortin H) 20-40 mg/day, rapid gradual dose reduction according to clinical findings.

Literature
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Cockayne SE (2000) Angry back syndrome is often due to marginal irritants: a study of 17 cases seen over 4 years. Contact Dermatitis 43: 280-282
Duarte I (2002) Excited skin syndrome: study of 39 patients. Am J Contact Dermat 13: 59-65