Delayed hypersensitivity to topical and systemic corticosteroids

Conflicts of Interest: The authors declare that they have no potential conflicts of interest. acetonide (40 mg/ml) for trochanteric bursitis (Fig. 1a). She reported similar cutaneous eruptions after the application of several anti-haemorrhoid creams or ointments during the past 2 years. Patch testing was first conducted with the TRUE Test® baseline series on the patient’s back; her own products could not be tested, as she had not kept these. According to ICDRG/ESCD criteria (1), patch tests were read on day (D) 2 and D4, and positive reactions to tixocortol 21-pivalate (++), budesonide (++) and hydrocortisone 17-butyrate (+++) were noted; moreover, nickel sulfate and potassium dichromate also gave positive reactions (+). We additionally patch tested with the corticosteroid series CS-1000 from Chemotechnique Diagnostics (Vellinge, Sweden), and this yielded positive reactions to each allergen on D2 and D4 (Table S1), with a 3+ reaction to hydrocortisone 17-butyrate 1.0% in ethanol (Fig. 1b).