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 corticosteroids of group A, C and D, including prednisolone-21-acetate and betamethasone valerate, but not of group B corticosteroids such as triamcinolone. After intradermal testing of corticosteroids the exanthema flared again and the patient was treated with oral triamcinolone, with rapid improvement of her symptoms. A literature review revealed that exanthematous reactions after systemic treatment with corticosteroids have been rarely reported. Since corticosteroids are essential emergency drugs, a safe corticosteroid should be identified for such patients. Patch and intradermal tests may be used for that purpose.
Bircher
A J
AJ
Department of Dermatology, University Hospital, Basel, Switzerland.
Levy
F
F
Langauer
S
S
Lepoittevin
J P
JP
D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D004361:Drug Tolerance; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007428:Intradermal Tests; D010328:Patch Tests; D011239:Prednisolone; D014221:Triamcinolone / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D014221:Triamcinolone; D011239:Prednisolone