CONTACT ALLERGY TO TOPICAL CORTICOSTEROIDS AND SYSTEMIC CONTACT-DERMATITIS FROM PREDNISOLONE WITH TOLERANCE OF TRIAMCINOLONE

We report the case of a 27-year-old female who had an allergic contact dermatitis to topical corticosteroids belonging to the corticosteroid groups A and D. Upon oral treatment with prednisolone a disseminated exanthema began within 24 h. Patch tests revealed sensitization to cor ticosteroids of group A, C and D, including prednisolone-21-acetate an d betamethasone valerate, but not of group B corticosteroids such as t riamcinolone. After intradermal testing of corticosteroids the exanthe ma flared again and the patient was treated with oral triamcinolone, w ith rapid improvement of her symptoms. A literature review revealed th at exanthematous reactions after systemic treatment with corticosteroi ds have been rarely reported. Since corticosteroids are essential emer gency drugs, a safe corticosteroid should be identified for such patie nts, Patch and intradermal tests may be used for that purpose.