Results of patch testing to a corticosteroid series: a retrospective review of 1188 patients during 6 years at Mayo Clinic.

BACKGROUND

Allergy to topical corticosteroids is more common than previously realized. To detect this allergy, a corticosteroid series is used for patch testing in addition to corticosteroid screens on a standard series.

OBJECTIVE

We sought to review our experience with patch testing to corticosteroid series.

METHODS

We conducted a retrospective study of patch testing to our corticosteroid series over 6 years (January 1, 2000-December 31, 2005).

RESULTS

Of 1188 patients patch tested to corticosteroid series, 127 (10.69%) had allergic reaction to at least one corticosteroid; 56 reacted to multiple corticosteroids. Rates of allergic patch test reaction to 19,611 individual corticosteroids were 0.41% to 5.03%. Rates of reaction to corticosteroid groups were 1.10% to 5.72%; concomitant reactions between groups were noted. Present screens on our standard series identified 74% of those detected on the corticosteroid series; tixocortol pivalate alone detected less than 50%.

LIMITATIONS

Limitations include that this study was retrospective and the possible interobserver variation in interpretation of patch tests.

CONCLUSION

In patients suggested to have corticosteroid allergy, patch testing confirms allergy in 10.69%; allergy is often to multiple corticosteroids and across groups. Screens on a standard series may detect 74% of those detected on a corticosteroid series.