[Allergic contact dermatitis due to corticosteroids: a 3-year retrospective study in a hospital skin allergy unit]

Corticosteroid contact dermatitis and its patch testing are subject to certain peculiarities that we should be aware of.

We performed a retrospective study of all patients who underwent patch tests with a corticosteroid battery in the Skin Allergy Unit of the Dermatology Department of Hospital General Universitario, Alicante, Spain, between October 2004 and June 2007.

During the study period, patch tests were performed on 1065 patients in our allergy unit. A corticosteroid battery was used in 34 patients (3.1 %). Fourteen patients were positive for budesonide or tixocortol in the standard battery; 20 were negative for these allergens but there was a clinical suspicion of steroid allergy. At least one positive reaction in the corticosteroid battery was observed in 15 patients (44.1 %). The substance most commonly implicated was budesonide (13 patients sensitized). The corticosteroid battery revealed sensitization to other groups of corticosteroids in 4 of the 15 patients with corticosteroid sensitization. Seventeen patients brought drugs that were also tested, obtaining positive results for 10 substances.

Allergens for contact dermatitis due to corticosteroids included in the standard battery (budesonide and tixocortol) detected 93 % of patients who are sensitized to steroids; there would appear to be little benefit in performing a corticosteroid battery if those markers are negative. The battery of corticosteroids and the drugs provided by patients were useful to define more exactly the corticosteroid classes that the patient should avoid.