Recently, several new allergens have been added to the T.R.U.E. Test. For topical steroid sensitive individuals the T.R.U.E Test includes: Tixocortol Pivalate (Class A), Budesonide, and Hydrocortisone Butyrate (Class D). Remember that cross reactivity among the various classes of steroids ie A, B, C , D is unpredictable.
If anyone is allergic to ANY of the steroid markers on patch testing put them on clocortolone and desoxymetasone (the only two Class C steroids) are the least likely topical steroids to cause sensitivity reactions.
Patients allergic to Tixocortol Pivalate have approximately 10% chance of being allergic to systemic prednisone so use oral dexamethasone (Class C) in these patients instead of oral prednisone.
