Contact allergy to corticosteroids in patients using inhaled or intranasal corticosteroids for allergic rhinitis or asthma.
BACKGROUND
Patients using topically applied corticosteroids are at risk of developing allergic contact hypersensitivity.


OBJECTIVE
To assess prevalence of allergic contact hypersensitivity reactions to inhaled or intranasal corticosteroids.


METHODS
A prospective study of 30 adult patients using inhaled or intranasal corticosteroids for conditions such as allergic rhinitis was performed. We used epicutaneous patch testing to determine the prevalence of allergic contact hypersensitivity to corticosteroids and common additives (propylene glycol and benzalkonium chloride) in inhaled and nasal corticosteroid preparations in this population.


RESULTS
Of 30 patients, 4 (13%) had positive patch test results. 3 (10%) were allergic reactions and 1 (3%) was an irritant reaction. Half of the reactions were to a corticosteroid (budesonide) and half were to a common preservative in nasal preparations (benzalkonium chloride).


CONCLUSIONS
This study supports other clinical evidence that contact dermatitis/mucositis from inhaled or intranasal corticosteroid products can occur. The corticosteroids or added agents such as preservatives can be causative and may result in allergic or irritant reactions, which can be relevant to clinical symptoms.
Bennett
M L
ML
Department of Dermatology, Wake Forest University School of Medicine and the Skin Surgery Center, Winston-Salem, NC 27106, USA.
Fountain
J M
JM
McCarty
M A
MA
Sherertz
E F
EF
D000280:Administration, Inhalation; D000281:Administration, Intranasal; D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D001548:Benzalkonium Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D010328:Patch Tests; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage / Q000009:adverse effects; D015995:Prevalence; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*
D001548:Benzalkonium Compounds; D001993:Bronchodilator Agents; D011310:Preservatives, Pharmaceutical; D019819:Budesonide