Effect of coadministration of corticosteroids on the development of contact sensitization

Transdermal administration of drugs can increase patient compliance and reduce side effects, but it can also cause contact sensitization. Corticosteroids frequently are used to suppress the local immune response; however, their use as a pretreatment for transdermal system application sites is not practical.

Our purpose was to determine the feasibility of suppressing contact sensitization by delivering a corticosteroid with the transdermal delivery systems.

Materials were applied continuously for 3 weeks to the same (protocol SS) or different (protocol AS) skin sites. Skin flux and appearance of sensitization were determined.

Coadministration of hydrocortisone reduced the incidence of sensitization by d-chlorpheniramine and benzoyl peroxide from 45% to 7.5% and from 20% to 2.3%, respectively, under protocol SS. Under protocol AS, sensitization by d-chlorpheniramine was reduced from 15% to 1%. Frequent exposure to the sensitizer plus corticosteroid induced tolerance to the sensitizer.

Sensitization by moderately immunogenic drugs after any length of exposure may be reduced to acceptable levels by the coadministration of hydrocortisone.