Possible anergy after generalized orally elicited allergic contact dermatitis to corticosteroid

Patch, prick or intradermal tests to detect delayed hypersensitivity to corticosteroids?

“… – two of them were taking immunomodulatory drugs (number 12, leflunomide and Medrol ® 5 mg/day; number 16, Medrol ® 10 mg/day along with an antihistamine medication, i.e. cetirizine); – possible loss of sensitization, or skin hyporeactivity, or anergy (4, 23); – false‐positive results during previous patch tests (vasodilatation); – false‐negative results during the current study (insufficient quantity of allergens in the patch test chamber, inadequate occlusion, etc. ); – patch tests prepared too far in advance (evaporation of the product, especially for the ethanol dilutions). …”

Systemic contact dermatitis

“…9 It is curious that prednisone can cause systemic contact dermatitis when given orally. 10,11 This was pointed out in a review by Thyssen and Maibach. 12 If a drug given systemically is an important treatment of a serious disease, it should not at the same time be marketed in a topical preparation intended for application on the skin.…”

“…There can be cross‐reactions between some of the drugs, as for example between gentamycin and neomycin 9 . It is curious that prednisone can cause systemic contact dermatitis when given orally 10,11 . This was pointed out in a review by Thyssen and Maibach 12 …”