title: Detection of contact hypersensitivity to topical corticosteroids with hydrocortisone-17-butyrate.
abstract: We showed earlier that most patients with contact dermatitis due to corticosteroids show cross-reactions when patch tested with hydrocortisone-17-butyrate (H-17-B). To test whether H-17-B could be used for detecting topical corticosteroid allergy, we screened patients undergoing routine patch testing with H-17-B. Patients with clearly allergic or doubtful/mildly irritant patch test reactions to H-17-B, and with a history suggesting topical corticosteroid allergy, were further tested with a large panel of steroid preparations. 20 out of 4039 patients (0.5%) showed definite allergic test reactions to corticosteroids. A further 165 patients with clinically suspected corticosteroid allergy were directly tested with a panel of steroid preparations; 14 patients showed positive patch test reactions. Altogether, 33 out of 34 patients with corticosteroid allergy had positive test reactions to H-17-B. Inclusion of 1.0% H-17-B in ethanol in the standard patch test series improves the diagnosis of topical corticosteroid hypersensitivity.
authors.affiliation: Department of Dermatology, Helsinki University Central Hospital, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Reitamo
authors.forename: A I
authors.initials: AI
authors.lastname: Lauerma
authors.forename: L
authors.initials: L
authors.lastname: Förström
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D003429:Cross Reactions; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000209:etiology*; D003879:Dermatologic Agents / Q000009:adverse effects; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D006854:Hydrocortisone / Q000031:analogs & derivatives*; D012882:Skin Tests
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; C007975:hydrocortisone-17-butyrate; D006854:Hydrocortisone