Allergic contact dermatitis and conjunctivitis to corticosteroids

Area of Science:

• Ophthalmology
• Dermatology
• Allergology

Background:

• Corticosteroid ointments are frequently used in ophthalmic practice.
• Allergic reactions to topical medications can manifest as dermato-conjunctivitis.
• Identifying specific allergens is essential for effective patient management.

Purpose of the Study:

• To report two cases of suspected allergic dermato-conjunctivitis caused by corticosteroid ointments.
• To evaluate the utility of patch testing in diagnosing allergic reactions to ophthalmic preparations.
• To recommend standardized patch testing protocols for ophthalmic allergens.

Main Methods:

• Two patients with suspected allergic dermato-conjunctivitis underwent patch testing.
• Testing included corticosteroids, antibacterial agents, preservatives, and ointment base components.
• Hydrocortisone (25%) in petrolatum was used for patch testing.

Main Results:

• Both patients exhibited positive patch test reactions to betamethasone valerate.
• One patient also showed positive reactions to hydrocortisone, neomycin, and a rubber additive.
• Patch testing successfully identified specific allergens responsible for the allergic reactions.

Conclusions:

• Corticosteroids and other components in ophthalmic ointments can be significant allergens.
• Routine patch testing should be incorporated into ophthalmic practice to detect sensitizers.
• Hydrocortisone (25%) in petrolatum is a suitable agent for patch testing in suspected cases.