Repetitive usage testing with budesonide in experimental nickel--allergic contact dermatitis in individuals hypersensitive to budesonide.
BACKGROUND
Contact allergy to topical corticosteroids on patch testing is well recognized, but the clinical significance is uncertain.


OBJECTIVE
To determine the clinical relevance of contact allergy to topical corticosteroids.


METHODS
Seven patients hypersensitive to both budesonide and nickel repeatedly applied budesonide, betamethasone valerate or the common base for both corticosteroids to areas of experimentally induced nickel dermatitis. Nineteen controls allergic to nickel, but not budesonide went through the same procedure.


RESULTS
Seventy-one per cent of the budesonide-allergic individuals experienced distant ipsilateral flares of toxicoderma-like eruptions, in addition to a severe deterioration of the experimental dermatitis treated with budesonide, i.e. increased erythema, and abundant papules and vesicles. The areas of dermatitis in all of the 19 controls healed uneventfully.


CONCLUSIONS
The clinical relevance of a contact allergy to budesonide was thus substantiated.
Isaksson
M
M
Department of Occupational and Environmental Dermatology, Malmö University Hospital, SE-205 02 Malmö, Sweden.
Bruze
M
M
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D019819:Budesonide / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D008875:Middle Aged; D009532:Nickel; D010328:Patch Tests; D012720:Severity of Illness Index; D012882:Skin Tests / Q000379:methods
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; C029938:nickel sulfate; D019819:Budesonide; D009532:Nickel