Hydrocortisone sensitivity: clinical features of fifty-nine cases.

BACKGROUND: Hypersensitivity to topical steroids is becoming increasingly recognized.

OBJECTIVE: Our purpose was to establish factors associated with allergy to topical hydrocortisone.

METHODS: Data from 59 consecutive patients allergic to hydrocortisone were compared with 199 consecutive patients who were not allergic to hydrocortisone.

RESULTS: Patients with stasis dermatitis and leg ulceration were significantly more likely to be allergic to hydrocortisone. In patients with hand eczema, in whom hydrocortisone sensitivity was less common, hydrocortisone was still a common allergen, occurring as frequently as wool alcohols and colophony. In four patients with atopic eczema, hydrocortisone was the only allergen. Duration of dermatitis was not important in determining the presence of hydrocortisone allergy. However, patients allergic to hydrocortisone were more likely to have multiple allergies when compared with control subjects.

CONCLUSION: Allergy to topical hydrocortisone is associated with stasis dermatitis and multiple positive patch test reactions.