Results of patch testing to a corticosteroid series: a retrospective review of 1188 patients during 6 years at Mayo Clinic.

Abstract

Allergy to topical corticosteroids is more common than previously realized. To detect this allergy, a corticosteroid series is used for patch testing in addition to corticosteroid screens on a standard series. We sought to review our experience with patch testing to corticosteroid series. We conducted a retrospective study of patch testing to our corticosteroid series over 6 years (January 1, 2000-December 31, 2005). Of 1188 patients patch tested to corticosteroid series, 127 (10.69%) had allergic reaction to at least one corticosteroid; 56 reacted to multiple corticosteroids. Rates of allergic patch test reaction to 19,611 individual corticosteroids were 0.41% to 5.03%. Rates of reaction to corticosteroid groups were 1.10% to 5.72%; concomitant reactions between groups were noted. Present screens on our standard series identified 74% of those detected on the corticosteroid series; tixocortol pivalate alone detected less than 50%. Limitations include that this study was retrospective and the possible interobserver variation in interpretation of patch tests. In patients suggested to have corticosteroid allergy, patch testing confirms allergy in 10.69%; allergy is often to multiple corticosteroids and across groups. Screens on a standard series may detect 74% of those detected on a corticosteroid series.