Abstract
A 36-year-old patient had used several topical corticosteroids for her psoriasis until 1983. In 1988, she used Amciderm ointment (amcinonide) for the first time and developed a generalized acute vesicular contact dermatitis after only three applications. Extensive patch testing including ointment vehicles revealed positive results for Amciderm ointment, amcinonide powder, fluocinolone acetonide, Jellin ointment, and triamcinolone acetonide. Among the corticosteroids the patient had used until 1983, only Jellin ointment (containing fluocinolone acetonide) was patch test positive. All of the steroids positive in the patch tests contain a 16a, 17a-cis-ketal structure. Because there were no sensitizations to other corticosteroids, it is assumed that the ketal structure was responsible for the Amciderm-induced contact dermatitis.
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