Nasal septal perforations during treatment with topical nasal glucocorticosteroids are generally not associated with contact allergy to steroids.
BACKGROUND
Mucosal ulcers and perforations of the nasal septum are very rare and may have several underlying causes. Contact allergy to steroids has been suggested as a possible aetiological factor in patients who develop perforations during topical steroid use.


METHODS
We have identified 13 subjects with perforations of their nasal septum and concomitant topical nasal steroid use. In order to evaluate whether these patients had developed contact allergy to steroids they underwent patch testing with an extended steroid series.


RESULTS
None of the subjects displayed any positive reaction to the steroids.


CONCLUSIONS
Sensitivity to glucocorticoids is a well-described phenomenon and may in selected subjects also be associated with local side effects to nasal sprays. However, contact allergy to steroids does not seem to be a general explanation for septal perforations in patients using nasal steroids.
Cervin
Anders
A
Department of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, Lund, Sweden. anders.cervin@onh.lu.se
Hansson
Christer
C
Greiff
Lennart
L
Andersson
Morgan
M
D000281:Administration, Intranasal; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000187:drug effects; D009300:Nasal Septum / Q000187:drug effects; D009668:Nose Diseases / Q000150:complications / Q000188:drug therapy*; D010328:Patch Tests / Q000379:methods; D014456:Ulcer / Q000209:etiology
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids