Systemic Contact Dermatitis to Inhaled and Intranasal Corticosteroids.

Systemic contact dermatitis (SCD) occurs when a sensitized individual develops a rash after systemic exposure to an allergen. The rash can occur at sites of previous dermatitis (or patch tests) or previously unaffected skin, such as in baboon syndrome. 1 Aquino M. Rosner G. Systemic contact dermatitis. Clin Rev Allergy Immunol. 2019; 56: 9-18 Crossref PubMed Scopus (27) Google Scholar Sensitization to corticosteroids is present in 0.5% to 5% of patients undergoing patch testing. 2 Baeck M. Chemelle J.-A. Terreux R. Drieghe J. Goossens A. Delayed hypersensitivity to corticosteroids in a series of 315 patients: clinical data and patch test results. Contact Dermatitis. 2009; 61: 163-175 Crossref PubMed Scopus (59) Google Scholar It is hypothesized that glyoxal and glutaraldehyde, metabolites of corticosteroids, act as haptens and bind to skin proteins, notably arginine, promoting sensitization. 2 Baeck M. Chemelle J.-A. Terreux R. Drieghe J. Goossens A. Delayed hypersensitivity to corticosteroids in a series of 315 patients: clinical data and patch test results. Contact Dermatitis. 2009; 61: 163-175 Crossref PubMed Scopus (59) Google Scholar Because SCD owing to inhaled or intranasal corticosteroid use is uncommon, we summarize the clinical characteristics of these patients through a systematic literature review, including a patient from our institution.