0.1% triamcinolone acetonide ointment and patch test responses

Abstract

The effect of topical steroids on patch test responsiveness was investigated in 15 subjects. A 0.1% triamcinolone acetonide ointment and a control preparation were applied three times daily to opposing sites on the upper part of the inner arms prior to patch testing. From a total of 18 pairs of patch tests applied to the 15 patients, substantial differences in the paired reactions were seen in only three patients after 96 hours. Of these, two had the more intense reaction on the control side, and the third had a greater reaction on the triamcinolone-pretreated side. Previously applied, intermediate-strength topical steroids are unlikely to prevent the detection of contact allergy by patch testing.

Assessment of budesonide patch tests

“…It has been suggested that anti-inflammatory effects induced by corticosteroids can suppress or extinguish patch test reactions (22,(26)(27)(28). However, this suggestion is regarded as controversial (24,29). Current study provides no proof that budesonide patch tests are suppressed by the corticosteroid at any of the dose levels and application times used here.…”

British Association of Dermatologists’ guidelines for the management of contact dermatitis 2017

“…This will help avoid the 'angry back syndrome' with numerous falsepositive results. 33 If a patient applies potent topical steroids to the back up to 2 days prior to the test being applied, [34][35][36] or is taking oral corticosteroids, 37 there is a significant risk of false-negative results and decreased reactivity.…”

Guidelines for the management of contact dermatitis: an update

“…This will help to avoid the 'angry back syndrome' with numerous false positives. 37 However, if a patient applies potent topical steroids to the back up to 2 days prior to the test being applied [38][39][40] (Quality of evidence I), or is taking oral corticosteroids or immunosuppressant drugs, then there is a significant risk of false negative results. It has been claimed that patch testing is reliable with doses of prednisolone up to 20 mg per day but that figure is based on poison ivy allergy, which causes strongly positive patch tests 41 (Quality of evidence II.iii).…”