Amcinonide Contact Dermatitis

A 35-year-old housewife who had been suffered from hand dermatitis visited our clinic on February 15th 1983. Erythema, erosion, fissure and scaling were recognized on the back of her hands. We applied her Visderm ointment and the eruptions oncel cleared. She visited our clinic again on October 26, 1983 with hand dermatitis. So we applied again Visderm ointment, but her eruptions became worse. We suspected contact dermatitis from Visderm ointment. And patch tests were performed. Visderm ointment and 0.1% amcinonide in white petrolatum showed positive reactions. When amcinonide was eliminated from Visderm ointment, the reactions became negative. So we considered it might be allergic contact dermatitis from amcinonide. Patch tests were performed with the steroids which had similar chemical structure to amcinonide. Positive reactions were recognized only to amcinonide. The cyclopentan which has 16,17-a-dioxy is regarded as the key structure of the reaction.