CONTACT HYPERSENSITIVITY TO CORTICOSTEROIDS IN ROUTINE PATCH TEST PATIENTS - A MULTICENTER STUDY OF THE SWISS CONTACT-DERMATITIS RESEARCH GROUP

Background: Contact hypersensitivity to corticosteroids is increasingl y reported and has been identified as a problem of considerable clinic al relevance, The prevalence of positive patch tests to corticosteroid s ranges from 0.2 up to 5%, Objective: The prevalence of positive patc h tests to corticosteroids in Switzerland was determined in a multi-ce ntre study of patients undergoing routine parch tests, Methods: As rep resentatives of corticosteroid groups, the following substances were u sed for screening: tixocortol pivalate and hydrocortisone for group A (hydrocortisone type), hydrocortisone butyrate for group D (hydrocorti sone butyrate type) and budesonide for both groups B (triamcinolone ty pe) and D, Patients positive for at least one corticosteroid were rete sted with the screening series and 12 corticosteroids commonly used in Switzerland, Results: Among 3,016 consecutive patients, 65 individual s (2.2%) with a total of 106 positive reactions were found, Retesting showed a concordance of 70-98%, depending on the corticosteroid and th e score of the positive reaction. In the subsequently tested corticost eroid series including 12 substances, 19 out of 56 screening-positive patients had a positive result to one or several corticosteroids. Ther e were only few evident cross-reactive patterns in between the cortico steroids tested, Conclusions: Corticosteroids should be included in ro utine patch testing, because contact sensitization to a corticosteroid is of considerable practical. importance, We confirm that as markers of corticosteroid sensitization tixocortol pivalate, budesonide and hy drocortisone butyrate may be suited, because there is no single cortic osteroid which is a marker for all four corticosteroid groups, Patch t est reactions of 2+ or higher have a better reproducibility than 1+ re actions.