Background Contact allergy to topical corticosteroids on patch testing is well recognized, but the clinical significance is uncertain.
Objectives To determine the clinical relevance of contact allergy to topical corticosteroids.
Methods Seven patients hypersensitive to both budesonide and nickel repeatedly applied budesonide, betamethasone valerate or the common base for both corticosteroids to areas of experimentally induced nickel dermatitis. Nineteen controls allergic to nickel, but not budesonide went through the same procedure.
Results Seventy-one per cent of the budesonide-allergic individuals experienced distant ipsilateral flares of toxicoderma-like eruptions, in addition to a severe deterioration of the experimental dermatitis treated with budesonide, i.e. increased erythema, and abundant papules and vesicles. The areas of dermatitis in all of the 19 controls healed uneventfully.
Conclusions The clinical relevance of a contact allergy to budesonide was thus substantiated.