Contact Allergy to Topical Corticosteroids in Atopic Dermatitis: Diagnostic Gaps in Baseline Patch Testing.
Hydrocortisone-17-butyrate contact allergy is more common in atopic dermatitis patients
Contact Allergy to Topical Corticosteroids in Atopic Dermatitis: Diagnostic Gaps in Baseline Patch Testing.
Chronic exposure to topical corticosteroids (topical corticosteroids) in patients with atopic dermatitis (atopic dermatitis) may increase the risk of allergic contact dermatitis (allergic contact dermatitis), which can mimic flares of the underlying disease and remain underrecognized.
To evaluate patterns of topical corticosteroids sensitization in patients with atopic dermatitis compared with patients without atopic dermatitis, with particular emphasis on the diagnostic limitations of baseline patch testing and the effect of test vehicle on allergen detection.
In this prospective study conducted between September 2023 and January 2024, 80 patients with atopic dermatitis and 80 patients without atopic dermatitis underwent patch testing.
atopic dermatitis patients are about 3 times more likely to react
Positive reactions occurred exclusively to hydrocortisone-17-butyrate 1.0% in ethanol, whereas hydrocortisone-17-butyrate 1.0% in petrolatum was negative in all tested subjects.
No positive reactions were observed to budesonide or tixocortol pivalate.
Sensitization to clobetasol-17-propionate was uncommon and observed only in adults.
Most reactions were first clearly detectable at 72 h or increased in intensity between 48 and 72 h, and one paediatric patient with atopic dermatitis had a delayed positive reaction detectable only on Day 7.
The Polish Baseline Series alone may fail to detect some potentially clinically relevant topical corticosteroids sensitizations in selected patients with atopic dermatitis.
Extended corticosteroid testing, attention to the test vehicle, and Day 7 readings may improve case detection in selected clinical scenarios, particularly in patients with persistent or apparently treatment-refractory atopic dermatitis.