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.