A COMPELLING CASE has been made for patch testing patients for corticosteroid allergy. In a study of 2073 patients screened for contact dermatitis, 2.9% to 4.8% were found to be allergic to one or more corticosteroids.1 Burden and Beck found 5.1% of their patch test patients in Manchester, England, were corticosteroid-sensitive.2 The work presented in this issue of the Archives3 argues convincingly for patch testing with budesonide and tixocortol to identify most of these individuals. Unfortunately, neither agent is currently available on a routine basis for patch testing in the United States. What then can a conscientious and well-read dermatologist do to ensure an accurate diagnosis for a patient's care?
Actually, several issues are involved in answering this question: what steroid would be an appropriate screening test (other than budesonide and tixocortol); what vehicle and concentration would be appropriate; and what is the role of intradermal testing?
Rietschel RL. Patch Testing for Corticosteroid Allergy in the United States. Arch Dermatol. 1995;131(1):91–92. doi:10.1001/archderm.1995.01690130095019
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