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December 1983

Topical Adrenal Steroids and Patch Tests

Author Affiliations

45-14 48th St Woodside, NY 11377

Arch Dermatol. 1983;119(12):956. doi:10.1001/archderm.1983.01650360002003

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To the Editor.—  In the January Archives (1983;119:3-4), Dahl and Jordan reported the following: "(1) Prior application of medium-strength topical corticosteroids is not a contraindication to patch testing and usually allows the detection of contact allergy by the 48-hour closed-patch test system. (2) Prior application of a medium-strength topical corticosteroid may suppress the intensity or appearance of inflammation to certain allergies at certain concentrations in certain patients."With regard to these conclusions, I have recently encountered two patients with an allergic contact dermatitis due to a neomycin-nystatin corticosteroid from the presence of ethylenediamine hydrochloride, used as a stabilizer. Patch tests with the neomycinnystatin corticosteroid itself were negative, but strongly positive patch tests to the ethylenediamine hydrochloride were obtained. This shows that the triamcinolone present in the corticosteroid suppressed the patch test reaction to ethylenediamine.However, three patients were allergic to the parabens in hydrocortisone. Positive reactions were obtained to both

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