Cross-reactions to systemic corticosteroids in patients contact sensitized to budesonide

Budesonide is a well-known contact sensitizer routinely patch tested in the baseline series of several countries. Prevalence of contact allergy to this corticosteroid ranges from 0.6% in Spain to 0.8% in the European surveillance system on contact allergies. Patients contact sensitized to budesonide typically develop only cutaneous reactions when this corticosteroid is administered systemically. Patients are difficult to manage, owing to the high frequency of cross-reactions not only among topical but also systemic corticosteroids (SCSs). In fact, patients previously contact sensitized to budesonide are at risk of systemic allergy caused by SCS, as described for patients with hydrocortisone hypersensitivity. Herein we present a study on patch tests with a series of SCS in patients with contact allergy to budesonide.