Delayed hypersensitivity reactions to corticosteroids applied to mucous membranes

Despite the widespread use of corticosteroids on the mucous membranes of the nose, eye and bronchial tree, mucosal contact sensitivity has apparently been uncommon. However, since the introduction of new corticosteroids such as tixocortol pivalate and budesonide, mucosal contact sensitivity, particularly that affecting the nasal mucosa, has increasingly been reported, Contact allergy on other mucosal surfaces and in the bronchial tree is very rare. We report three women who had contact allergy to tixocortol pivalate or budesonide in nasal sprays, and one woman who had an allergic contact stomatitis from tixocortol pivalate in oral lozenges.