Allergic Contact Dermatitis Following Ocular Use of Corticosteroids

Aim: To study the clinical features and to identify the molecules responsible for contact-allergic reactions following ocular use of corticosteroid (CS) preparations. Design: Observational case series. Methods: We reviewed the clinical data, the patch test results, and sensitization sources in patients with a CS contact allergy, who have been patch tested in the K. U. Leuven Dermatology department during an 18-year period. Results: Eighteen subjects (out of 315 with CS delayed-type hypersensitivity) presented with allergic manifestations (conjunctivitis, eczema of the face, periocular skin or eyelids) of delayed-type hypersensitivity reactions to the use of CS-containing ocular preparations. The most common allergen was hydrocortisone, but most patients presented with multiple positive tests, not only to other CSs, but also to other active principles, preservatives, and vehicle components. Conclusions: Ophthalmic CSs, despite their anti-inflammatory and antiallergic properties, may produce contact-allergic reactions.