[Contact allergy to local steroids. Contact allergy to corticosteroids among consecutively tested patients with eczema].

We studied the frequency of contact dermatitis to corticosteroids in consecutive eczema patients and the relevance of positive patch test reactions. Of 2,742 patients patch tested at the Dermatology Clinic at Odense University Hospital between June 1991 and December 1995, 65 patients (47 women and 18 men) or 2.4% had a positive reaction to one or more of the corticosteroids tested. Forty (1.45%) had a positive reaction to budesonide 1% pet. in the standard series. For a one-year period 662 consecutive eczema patients were routinely patch tested with a corticosteroid series consisting of five steroid allergens, and 17 had a positive reaction to at least one of these (2.6%). Budesonide allergy was most often encountered, followed by hydrocortisone, tixocortol pivalate and hydrocortisone-17-butyrate. Betamethasone valerate, triamcinolone acetonide and clobetasol propionate rarely caused contact allergy. The corticosteroid allergy was of current relevance in about one third of the cases. Corticosteroid contact allergy is an uncommon adverse effect, in relation to the number of patients with inflammatory skin diseases who are treated with topical corticosteroids. In patients with longstanding eczematous skin disease, who do not improve or deteriorate during topical corticosteroid therapy, contact allergy to these drugs should be suspected and relevant patch tests should be performed to sort out concomitant reactions. Future treatment with corticosteroids must take into account possible cross-reactions.