Hypersensitivity to topical hydrocortisone is becoming increasingly re
cognized. We present further evidence that this is mediated via a dela
yed-type hypersensitivity reaction. A hydrocortisone: albumin complex
was able to induce a proliferative response in the peripheral blood mo
nonuclear cells of patients allergic to hydrocortisone. Protein bindin
g of hydrocortisone or a degradation product may be important in the d
evelopment of corticosteroid allergy.