Can an imidazolidinyl urea-preserved corticosteroid cream be safely used in individuals hypersensitive to formaldehyde?

A topical corticosteroid preparation on the Swedish market, Flutivate cream, contains a fairly high concentration of formaldehyde (FA). In this study, we have investigated the clinical relevance of contact allergy to FA when treating an allergic eczema with Flutivate cream, containing an FA-releasing preservative. In a randomized, double-blind study, 7 patients hypersensitive to both FA and nickel repeatedly applied Flutivate cream containing FA or Betnovate cream not containing FA to areas of experimentally induced nickel dermatitis. 17 controls allergic to nickel, but not FA, went through the same procedure. In 29 per cent of the FA-allergic individuals, the experimental dermatitis healed when treated with Flutivate cream compared with 71 per cent of the controls (P = 0.04). The conclusion to draw from this study is that an individual hypersensitive to FA should not use the corticosteroid preparation Flutivate cream on dermatitis skin.