When I editorialized on patch testing for corticosteroid allergy, budesonide was unavailable in the United States.1 Late in 1994, the US Food and Drug Administration approved a new nasal inhaler known as Rhinocort, which is budesonide made available in a metered-dose apparatus. The 7-g canister contains 200 metered doses, each containing approximately 32 mg of micronized budesonide.
I had the opportunity to conduct a patch test on a patient with 0.1% budesonide in petrolatum, and an extreme reaction (3+) developed at 96 hours. I recently retested him with budesonide sprayed directly into a Finn chamber and applied to his back. This was done with one activation directly to the Finn chamber, with successive Finn chambers containing additional activations, up to a total of nine activations. He underwent retesting with 0.1% budesonide in petrolatum. At 48 hours, all of the tests showed equally positive results, indicating that one activation
Rietschel RL. Budesonide Patch Testing. Arch Dermatol. 1995;131(12):1466-1467. doi:10.1001/archderm.1995.01690240132032