Comparative evaluation of steroid sensitivity in various dermatoses with control group through histopathological examination and patch testing

Abstract

Background: Topical corticosteroids are widely used for treating various dermatoses. People have been self-medicating them for fungal infections, pigmentary disorders, and for many other dermatoses. This overzealous and irrational use of corticosteroid makes individuals susceptible for its adverse effects. Aim: The aim of this study was to evaluate steroid sensitivity in various dermatoses. Materials and Methods: Patch testing with Indian standard series and corticosteroid series was performed in sixty subjects where thirty patients were cases and thirty were controls. Histopathological examination and As it is (ASIS) were done only for the case group. Patches were applied on the back for 48 h and reading was done on day 2, day 4, and day 7 according to the International Contact Dermatitis Research group grading. Results: The maximum cases were in the age group of 20–30 years (33.3%) while 31–40 years was the most common age range (50%) among controls. Among the case group, 60% were male and 40% were female. Maximum patients affected in the case group were homemakers (36.7%) followed by laborers (13.3%). The case group showed 16.7% positive patch test reactions while none were positive in the control group. Thiomersal was positive in 13.3% of cases and neomycin in 3.3% of cases. ASIS was negative in all cases. Thiomersal is commonly used as a preservative in topical medicaments, cosmetics, and vaccines. Conclusions: Steroid sensitivity is hard to diagnose clinically, thereby causing difficulty in managing such cases. Patch test is a noninvasive gold standard procedure without major adverse effects and helps in treating the dermatoses with appropriate class of corticosteroid by avoiding the suspected allergen.