ABSTRACT
In one study, in 4 of 7 patients who had previously had a positive patch test to budesonide, inhalation of budesonide resulted in reactivation of these patch tests within 24 hours, proving systemic contact dermatitis from mucosal absorption of the corticosteroid. However, as budesonide is used in nasal and pulmonary inhalation preparations only, it must be assumed that most reactions to budesonide are cross-reactions to other corticosteroids, attesting to its efficacy as a screening agent for corticosteroid allergy. The case series of 5 similar patients with allergic contact dermatitis from the same brand of 0.05% budesonide-containing ointment and cream was reported from Japan. The chapter discusses the Japanese literature and found 34 more reported cases of allergic contact dermatitis to budesonide in 15 articles published in the period 1991-1992. It argues that a colleague had observed late positive reactions to budesonide in 2 patients, during a systematic late patch test reading.
