Patients with airborne sensitization/contact dermatitis from budesonide‐containing aerosols ‘by proxy’

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Abstract
Background: Inhalation corticosteroids (CSs), despite their wide use, rarely cause sensitization in subjects administering them.Objective: To determine the cause of sensitization and/or of allergic contact dermatitis which occurred in air‐exposed body areas of patients reacting to corticosteroids and to budesonide, in particular.Methods: We reviewed the patch test results and sensitization sources in patients who reacted positively to corticosteroids tested in the K.U. Leuven Dermatology department during an 18‐year period.Results: Fifteen subjects, not themselves treated by budesonide‐containing aerosols, but taking care of/or living together with patients who used them because of a chronic respiratory affection, appeared to have been sensitized by airborne exposure and/or presented with airborne allergic contact dermatitis from them.Conclusion: Air exposure to inhalation corticosteroids used ‘by proxy’ and to budesonide, in particular, needs to be taken into account as a potential cause of primary sensitization and/or airborne allergic contact dermatitis, sometimes also in an occupational context.

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