Corticosteroid-induced contact dermatitis: a pragmatic approach.

It is only in the past 10 years that the allergenic potential of topical corticosteroids has been fully realized. This has an important impact on the management of patients with chronic eczematous eruptions. Nonhalogenated topical steroids are more frequent sensitizers than halogenated molecules. Tixocortol pivalate and budesonide should be added to the standard series of patch test allergens. The topical steroid products that the patient has used should also be tested. If a patient has a positive reaction to tixocortol pivalate and/or budesonide then further patch testing with a commercial corticosteroid series should be undertaken.