The prevalence of corticosteroid allergy in two U.K. centres: prescribing implications

Allergic contact dermatitis to topical corticosteroids is a common problem, seen in up to 6% of patients undergoing patch testing. Rates of steroid allergy vary widely both within and between countries. It has previously been shown that non-fluorinated steroids degrade and react with arginine more rapidly in an in vitro system and may therefore be more likely to sensitize than fluorinated steroids. We have compared the rates of steroid allergy and corticosteroid prescribing habits in two different areas in England to observe the relationship between these factors. The results suggest that predominant use of non-fluorinated corticosteroids (hydrocortisone, hydrocortisone-17-butyrate and budesonide) results in a higher prevalence of corticosteroid contact allergy in comparison with those areas using a greater proportion of fluorinated corticosteroids.