Dermatite fotoalérgica ao pigmento azul de tatuagens: relato de um caso e breve revisão da literatura / Photoallergic dermatitis due to the blue pigment in tattoos: a case report and brief literature review

A prática de tatuagens é muito antiga e atualmente tornou-se extremamente popular, porém traz consigo riscos que não podem ser ignorados. As tintas utilizadas nas tatuagens são um fator importante para o aparecimento de reações adversas. A reação de hipersensibilidade aos pigmentos das tintas é uma das mais comuns. Entre elas, encontram-se reações alérgicas tipo dermatites de contato ou reações de fotossensibilidade, sendo esta última o motivo deste relato. O tratamento indicado é o uso de corticoides e a fotoproteção. Neste artigo, discorreremos especificamente sobre a reação de fotossensibilidade ao pigmento azul, com o relato de um caso e breve revisão da literatura.

Tattooing is a very old practice that has become extremely popular in recent years; however, it carries risks that cannot be ignored. The inks used in tattoos are an important factor for the appearance of adverse reactions. Hypersensitivity reactions to the pigments in the inks are some of the most common. These include allergic reactions such as contact dermatitis or photosensitivity reactions, the latter being the reason for this report. The recommended treatment is the use of corticosteroids and photoprotection. In this article, we will specifically discuss the photosensitivity reaction to the blue pigment with a case report and a brief literature review.

Spontaneous and experimental poisoning by Froelichia humboldtiana in cattle / Intoxicação espontânea e experimental por Froelichia humboldtiana em bovinos

The aim of this work was to describe the epidemiological, clinical and pathological aspects of two outbreaks of spontaneous poisoning caused by Froelichia humboldtiana in cattle in Pernambuco, northeastern Brazil and reproduce experimentally this poisoning in cattle. Spontaneous poisonings of primary photosensitization occurred in two farms at the municipalities of Cachoeirinha and São Caetano and affected twenty-two adult bovines and two suckling calves after the rainy season. All bovines have recovered 21 days after they were removed from the pasture. To reproduce experimental poisoning, three cows and a calf were maintained in a pasture with 1ha composed by F. humboldtiana during 14 days. Clinical signs and skin lesions were similar in both spontaneous and experimental poisoning and consisted of cutaneous itching and hyperemia of non-pigmented areas of skin that evolved into edema, exudative dermatitis and extensive areas of skin necrosis. Serum levels of aspartate aminotransferase (AST), gamma glutamyltransferase (GGT), total, direct and indirect bilirubin were normal in all cattle examined. Histologically, lesions consisted of epidermal necrosis, hyperkeratosis with large amounts of degenerate neutrophils and acanthosis. In the dermis, edema and inflammatory infiltrate composed of eosinophils, lymphocytes and plasma cells mainly around the blood vessels were observed. In the experimental group, clinical signs of photosensitization were observed after the third day of F. humboldtiana consumption. The suckling calf displayed mild clinical signs of photodermatitis on the 8th day of the experiment. It was estimated that the average consumption of F. humboldtiana necessary to initiate clinical signs in each adult bovine was 78kg.(AU)

Os objetivos deste trabalho foram descrever os aspectos epidemiológicos, clínicos e patológicos de dois surtos de intoxicação por Froelichia humboldtiana em bovinos em Pernambuco e reproduzir experimentalmente essa intoxicação em bovinos. Intoxicações espontâneas foram observadas após o início do período chuvoso nos municípios de Cachoerinha e São Caetano. Vinte e dois bovinos apresentaram sinais clínicos e lesões cutâneas compatíveis com fotossensibilização primária, dentre os quais, dois bezerros lactentes. Todos os bovinos se recuperaram totalmente cerca de 21 dias após serem retirados da pastagem. Para reproduzir experimentalmente a intoxicação, três vacas, uma delas com bezerro ao pé, foram mantidas em um piquete de 1ha composto por F. humboldtiana por 14 dias consecutivos. O quadro clínico e as lesões tegumentares, tanto nos bovinos intoxicados nos surtos espontâneos, quanto nos bovinos do experimento consistiram em prurido e hiperemia em áreas despigmentadas de pele, que evoluíam para edema, dermatite exsudativa e necrose de áreas extensas de pele. Em todos os bovinos examinados, os níveis séricos de aspartato aminotransferase (AST), gamaglutamiltransferase (GGT), bilirrubina total, direta e indireta estavam normais. Histologicamente, as lesões consistiram em necrose da epiderme, hiperqueratose com grande quantidade de neutrófilos degenerados e acantose. Na derme havia edema e infiltrado inflamatório composto por eosinófilos, linfócitos e plasmócitos principalmente ao redor dos vasos sanguíneos. Nos bovinos do experimento, sinais clínicos de fotossensibilização foram observados após o terceiro dia de consumo de F. humboldtiana. O bezerro lactente apresentou sinais clínicos leves de fotodermatite no 8º dia do experimento. Estimou-se que o consumo médio de matéria seca de F. humboldtiana necessário para iniciar os sinais clínicos em cada bovino adulto foi de 78kg.(AU)

Dermatitis de contacto fotoalérgica y test de fotoparches: revisión de la literatura y aplicación de la técnica en clínica alemana de Santiago / Photoallergic contact dermatitis and test photopatches: literature review and application of the technique at clínica alemana de Santiago

Las fotodermatosis son un conjunto de patologías cutáneas originadas o agravadas por exposición a radiación ya sea solar o artificial. Se clasifican en cuatro categorías: 1. Idiopáticas o mediadas inmunológicamente 2. Dermatosis fotoagravadas, 3. Fotosensibilidad inducida por agentes y 4. Trastornos por reparación defectuosa del ADN. La fotosensibilidad inducida por agentes consiste en reacciones secundarias a la exposición de ciertos químicos, llamados fotosensibilizadores y a distintos tipos de radiación lumínica. Los fotosensibilizadores pueden ser de origen endógeno o exógeno, aquellos exógenos provienen desde el ambiente, fármacos u otros productos (tanto sistémicos como tópicos), los cuales sufren modificaciones estructurales al entrar en contacto con radiación, provocando como consecuencia, distintas manifestaciones cutáneas. En este artículo se revisarán principalmente las reacciones fototóxicas y fotoalérgicas (ambas, reacciones de fotosensibilidad inducidas por agentes exógenos) indagando en sus diferencias y el enfrentamiento clínico de cada una. También, se revisarán los exámenes que permiten estudiar los distintos diagnósticos diferenciales, especialmente el test de fotoparches, el cual está cobrando cada vez más importancia en la práctica clínica.

Photodermatoses are a group of skin diseases induced or aggravated by exposure to radiation, whether solar or artificial. They are classified into four general categories: 1. Idiopathic or immunologically mediated photodermatoses 2. Photoexacerbated dermatoses 3. Agent induced photosensitivity 4. DNA repair defects Photosensitivity induced by agents are secondary reactions to the exposure to some chemicals, called photosensitizers, and to different types of light radiation. Photosensitizers can be classified as exogenous or endogenous. Exogenous agents come from the environment, drugs or other products (both systemic and topical), which undergo structural changes when they come into contact with radiation, causing different skin manifestations as consequence. Differences between phototoxic and photoallergic reactions (both photosensitivity reactions induced by exogenous agents), the clinical approach of each one of them, and available tests that are used to make a diagnosis, especially, photo patch test will be reviewed in this article

Metformin-induced Photocontact Dermatitis in a 67-year-old male: A case report

Introduction@#Photocontact dermatitis is a type IV delayed hypersensitivity response to an allergen that is activated by radiation energy. Its incidence is uncertain and only a small number of drugs causing such reaction have been studied. This is a case of a 67-year-old filipino male, diabetic, who presented with scaly, erythematous, and hyperpigmented plaques with areas of desquamation and erosions on sunexposed areas of the skin after taking metformin.@*Case@#Four months prior to consult, the patient was diagnosed with type 2 diabetes mellitus and was started on metformin therapy. Days later, he started noticing scaly, erythematous and hyperpigmented plaques with areas of desquamation and erosions on sun-exposed areas, namely the upper and lower extremities, posterior neck, and forehead. There was notable sparing of areas that are usually covered with clothing such as the torso, inguina and both thighs. There were also no lesions on the scalp, palmar aspect of the hands and plantar surface of the feet. Skin biopsy was considered but was not done per patient’s preference. After discontinuation of metformin and avoidance from sun exposure, the skin lesions gradually improved.@*Conclusion@#Metformin is rarely associated with adverse skin reactions. The diagnosis of photocontact dermatitis as a side effect of metformin needs to be considered as a differential diagnosis in patients who present with skin rashes, especially in sun-exposed areas. It is recommended that there should be a high-index of suspicion for adverse drug reactions in such patients. This would reduce medical errors and medical cost and would result to prompt initiation of appropriate treatment.

Fitofotodermatite por Ruta graveolens com manifestação cutânea extensa / Phytophotodermatitis due to Ruta graveolens with extensive cutaneous manifestation

Dermatite de contato por planta ou fitodermatite é uma erupção cutânea resultante do contato com substâncias produzidas por diferentes espécies de vegetais. Ruta graveolens, popularmente conhecida como arruda, é uma planta da família das Rutaceae, que inclui algumas frutas cítricas, e contém inúmeras substâncias químicas fotossensíveis, incluindo os furocumarínicos. Relatamos um caso de reação de fitofototoxicidade grave em uma paciente que usou uma infusão de arruda pelas supostas qualidades ”místicas e purificadoras” da planta com extensa erupção cutânea.

Plant dermatitis or phytodermatitis is a cutaneous eruption resulting from contact with substances produced by different plant species. Ruta graveolens, popular known as common rue, is an herbal plant from the Rutaceae family, which includes the citrus fruits, and contains numerous photosensitizing substances, including furocoumarins. We report a severe case of phytophototoxicity reaction in a patient who used a common rue infusion because of its “powerful and purification” qualities.

Plantas relacionadas con fitofotodermatitis en Isla de Pascua, Chile / Plants related with phytophotodermatitis in Easter Island, Chile

La fitofotodermatitis es una enfermedad fototóxica caracterizada por la exposición de la piel a agentes fotosensibles (furocumarinas) que cambian su configuración en presencia de luz UV-A, resultando en daño cutáneo de magnitud variable según condiciones ambientales del huésped. Se identificó las plantas que contienen furocumarinas y se buscó su presencia en Isla de Pascua. Se encontraron cuatro especies en la vegetación de Isla de Pascua que están relacionadas con la fitofotodermatitis: Apium graveolens (apio), Daucus carota (zanahoria), Ficus carica (higuera y Citrus limon (limonero). El apio y la zanahoria se distribuyen principalmente en plantaciones rurales, mientras la higuera se encuentra distribuida en numerosos lugares urbanos y rurales de la isla, y el limonero está presente en sitios que reciben baja afluencia de turistas. La exposición cutánea a bebidas alcohólicas preparadas con cítricos y luz UV-A también pueden causar la patología.

Phytophotodermatitis is a phototoxic disease characterized by skin exposure to photosensitizing agents (furocoumarins), which change their configuration when exposed to UV-A ligth, resulting in variable skin damage according to environmental and host conditions. Plants containing forocoumarins were searched in Easter Island. Four species were identified in Easter Island s vegetation related with phytophotodermatitis: Apium graveolens (celery), Daucus carota (carrot), Ficus carica (fig tree) and Citrus limon (lemon tree). The celery and the carrot are distributed in numerous urban and rural plantations, the fig tree is distributed in numerous urban and rural places of the island, while the lemon tree is present in sites that receive few tourists. The skin exposition to alcoholic drinks prepared with citrus fruits plus UV-A light can also cause the disease.

A Case of Photoallergic Dermatitis due to Fluorescein / 대한피부과학회지

Fluorescein has been used for decades in ophthalmology for fluorescence angiography and it is the only fluorophore routinely used in experimental dermatology for in vivo study of the skin. It absorbs blue light, with peak absorption and excitation wavelengths between 465 and 490 nm and fluoresces at yellow-green wavelengths of 520~530 nm. The most common side effects are nausea and vomiting, and other adverse events such as a vasovagal response, cardiac or respiratory effects, neurologic manifestations or allergy, including anaphylaxis, were also reported. But a photosensitive reaction to fluorescein is very rare. We report here on a case of photoallergic dermatitis due to fluorescein after fluorescence angiography.

Fotossensibilização primária em eqüídeos e ruminantes no semi-árido causada por Froelichia humboldtiana (Amaranthaceae) / Primary photosensitization in equidae and ruminants in the Brazilian semi-arid caused by Froelichia humboldtiana (Amaranthaceae)

Fotossensibilização é freqüente em eqüinos no semi-árido da região Nordeste, mas jumentos, mulas, ovinos e bovinos são, também, afetados. A dermatite afeta, principalmente, áreas de pele despigmentadas e os animais se recuperam após serem retirados das pastagens. Para comprovar a etiologia da enfermidade Froelichia humboldtiana (Roem. et Schult.) Seub., coletada no campo foi administrada no mesmo dia da colheita ou após ser mantida em refrigerador por 1-4 dias, por períodos de 30 ou mais dias, ad libitum como único alimento, a 2 jumentos e um ovino branco e, como único alimento volumoso, a um eqüino branco. Esses animais não manifestaram sinais clínicos e as atividades séricas de gama-glutamiltransferase (GGT), aspartato-aminotransferase (AST) e alanino-aminotransferase (ALT) ficaram dentro dos valores normais. Em outro experimento, um ovino foi colocado a pastar diariamente, durante o dia, preso por uma corda em uma área que tinha exclusivamente F. humboldtiana, por um período de 26 dias. Lesões características de fotossensibilização foram observadas 4-5 dias após o início do experimento. Após cessar o consumo da planta, no 26º dia, o ovino recuperou-se totalmente em 30 dias. Em outro experimento, 4 ovinos foram também colocados, presos por cordas, na mesma área. Outros 4 permaneceram como controles em uma pastagem vizinha, mas sem F. humboldtiana. Lesões de pele, características de fotossensibilização foram observadas após 11-25 dias de consumo de F. humboldtiana. As atividades séricas de AST e GGT, e os níveis de bilirrubina sérica permaneceram dentro dos valores normais. No final do período de permanência em pastagens de F. humboldtiana, 2 ovinos foram abatidos e 2 foram retirados da pastagem. Os que foram abatidos não apresentaram lesões macroscópicas nem histológicas do fígado; os outros dois se recuperaram das lesões da pele 17 e 20 dias após o fim do pastejo. Uma égua e seu potro foram colocados na mesma pastagem com F. humboldtiana...

Photosensitization is common in the Brazilian semiarid, affecting mainly horses, but also donkeys, mules, sheep and cattle. The dermatitis affects mainly non pigmented skin, and the animals recover after being withdrawn from the pastures. To demonstrate the etiology of the disease, Froelichia humboldtiana (Roem. et Schult.) Seub., collected in the field one or two times a week and kept in the refrigerator for 1-4 days, was administered for 30 or more days as the only food ad libitum to 2 donkeys and one white sheep, and as the only forage ad libitum, to one white horse. No clinical signs were observed in those animals, and serum activities of aspartate-aminotransferase (AST), alanine-aminotransferase (AST), and gamma-glutamyltransferase (GGT) were within normal ranges. In another experiment, one sheep was tied by a rope, during the day, in a pasture of exclusively F. humboldtiana for a 26 days period. Skin lesions characteristic of photosensitization appeared 4-5 days after the start of the experiment and became severe until day 26. After the withdrawal of the animal from the pasture on day 26 it fully recovered within 30 days. In another experiment, 4 sheep were tied by ropes in the same pasture, during the day, for a 29 days period. Another 4 control sheep were maintained in a neighboring pasture without F. humboldtiana. Skin lesions characteristic of photosensitization were observed after 11-25 days of F. humboldtiana grazing. Serum activities of AST and GGT, and serum levels of bilirubin were within normal ranges. At the end of the 29 days grazing F. humboldtiana, 2 sheep were euthanized, and 2 were withdrawn from the pastures. No gross or histologic liver lesions were observed on the 2 sheep euthanized; the other 2 sheep recovered within 17 and 20 days after the end of grazing. One mare and its foal grazed in the same pasture during 44 days. The mare that had a pigmented skin had no dermatitis, but the foal showed dermatitis on the...

Hydroa vacciniforme in an adolescent girl

Hydroa vacciniforme [HV] is a rare photosensitivity disorder with onset in childhood. Recurrent vesicles, bullae and crusting occur on sun-exposed skin that heals with vacciniform scarring. This rare disorder is hereby reported in an adolescent girl who developed a severe episode of hydroa vacciniforme on a hot sunny day during harvesting season. She had repeated episodes afterwards in succession until she was appropriately sun-screened. Her lesions healed without scarring because of early reporting, short-lived episodes, early diagnosis and response to appropriate therapy

Curso clínico de la erupción polimorfa lumínica con medidas de fotoprotección con categoría ULTRA / Evolution of polymorphic light eruption using category ULTRA photoprotective measures

La erupción polimorfa lumínica (EPL) es la fotodermatosis idiopática más común. Suele presentarse en primavera y se caracteriza por la aparición de lesiones pruriginosas de diferente morfología en las zonas expuestas al sol. Aunque existen distintos tratamientos, se considera que la mejor medida consiste en restringir la exposición y utilizar fotoprotectores del factor alto. En este estudio epidemiológico se han evaluado las características clínicas y la revolución de la EPL con medidas de fotoprotección con categoría ULTRA (FPS 90) durante tres meses es una muestra de 26 pacientes. La gravedad de los síntomas y la intensidad de prurito disminuyeron significativamente en tan sólo 15 días hasta niveles irrelevantes y siguió disminuyendo hasta el final del estudio. Los resultados sugieren que la utilización del fotoprotector FPS 90 ayuda a la resolución de las lesiones del brote agudi del EPL.

Photo-onycholysis induced by doxycycline: a new clinical feature

Photo-onycholysis is a rare complication of tetracyclines. Three clinical subtypes are usually reported. In type I, several nails are often involved and the separated portion of the nail is half-moon-shaped with proximal convexity. In type II, only one nail is involved and there is a proximal notch due to the concentration of ultraviolet rays. Type III is medio-ungueal, away from distal end and lateral folds of the nail. We report a new form of photo-onycholysis induced by doxycycline resembling the latter subtype. In fact there is no involvement of the distal or disto-lateral end of the nail but the separation of the nail starts from the proximal fold. As far as we know, such a clinical feature has not been reported before

A Case of Photoallergic Contact Dermatitis due to Benzophenone-3 / 대한피부과학회지

Benzophenones are aromatic ketone derivatives of dibenzoylmethane, exhibiting absorption characteristics not only in the UVC and UVB spectral ranges but also in part of the UVA range, up to 360nm. They are commonly used for extending the spectrum of photoprotection. Benzophenone-3, one of the most popular benzophenones, is the most common cause of sunscreen allergy as well as a substitute of PABA. We report a case of photoallergic contact dermatitis due to benzophenone-3 of sunscreen.

In vitro Sun Protection Factors (SPFs) of Sunscreen and Skin Irritability / 대한피부과학회지

BACKGROUND: Use of suncreen is strongly recommended to prevent the harmful effect by ultraviolet (UV) ray, and new diverse synthetic chemicals have been screened and put forward as effective UV filters. However, the most important aspect of developing a novel UV filter is safety. OBJECTIVE: This study aimed to find out if there was any correlation between a high in vitro SPF (Sun Protection Factor) index and skin irritation by using standardized formulations containing organic or inorganic, active sunscreen ingredients. METHODS: HRIPT (Human repeated insult patch test) was conducted on with fifty subjects (male to female ratio as 3: 2, average age was 21.6+/-2.9 years), and in vitro SPFs of sunscreen formulations were measured. Patch tested UV filters (UVA, UVB, and physical blockers) were butyl methoxy dibenzoyl methane (BMDM 2%, 5%), benzophenone-3 (2%, 5%), homosalate (10%, 20%), octyl methoxy cinnamate (10%, 20%), octyl salicylate (5%, 10%), octocrylene (10%, 20%), zinc oxide (10%, 20%)and titanium dioxide (10%, 20%). Skin bioengineering measurements for capacitance, erythema, laser doppler blood flow were carried out before and after HRIPT to compare the subjective observation errors of the conventional scoring system of skin irritation (ICDRG standard). To explore any photoirritability, phototoxicity or photoallergy, individual UV filters were photopatch tested with higher concentrations (5%, 20%) than those of usual photopatch sunscreen test series RESULTS: The range of in vitro SPF revealed from 3.6 to 52.8. A doubtful, rather transient, weak erythema (+0.5) was noted in eight subjects, though the apparent skin irritation reaction can be estimated at over +1 by ICDRG guideline was not found during the HRIPT. The weak erythemas were observed at 20% homosalate, 10% octyl salicylate, 5% octyl salicylate, 20% octyl methoxycinnamate, 10% octyl methoxycinnamate, 10% octocrylene, 20% octocrylene, 5% BMDM, respectively in frequency, thus UVB filters of high concentration were related to weak irritation. Nosignificant differences in the measured skin bioengineering parameters were detected between before and after the HRIPT. Photopatch test failed to find any photoirritability and photoallergy. CONCLUSION: Skin irritability due to high in vitro SPFs appeared to be minimal or remained within the safety margin. However, a weak irritation was suspected from the organic UVB filters under the higher concentration range than its recommended range by regulatory guidelines. As for the newly developed, diverse formulations of multi-organic UV filters claiming high SPFs, dermatologists could consider the potential irritation reactions when it is preferentially used within a population.

A Study about the Skin and General Disease Pattern of the Vietnam Veterans Exposed to Dioxin / 대한피부과학회지

BACKGROUND: Vietnam veterans have suffered from a number of skin and general diseases. But in Korea, there are few reports about the relationship between dioxin and skin disease and dermatologists need more information about it. OBJECTIVE: The purpose of this study was to evaluate the skin and general disease pattern of Koreans who have a history of exposure to dioxin in Vietnam. METHODS: 332 Vietnam veterans who visited St. Mary's hospital between July, 2001 and September, 2001. We perfomed a clinical evaluation, physical examination, medical history, serum and urine chemistry, electrocardiogram, electrodiagnostic study, and a roentgenographic study. For dermatologic evaluation, pathologic examination, KOH mount, fungus culture, and phototest were performed. RESULTS: 1. Among the 332 participating soldiers in the Vietnam war, the mean age of patient was 56.9 years old (the youngest-53 years, the oldest-61 years old). 2. The prevalence of hypertension, hyperlipidemia, diabetes mellitus, liver disease, and peripheral neuropathy of subjects was 12.0%, 6.9%, 5.7%, 4.5%, and 1.2%. 3. The prevalence of xerotic eczema, seborrheic dermatitis, psoriasis vulgaris, photoallergic dermatitis, and chronic urticaria of subjects was 3.9%, 3.9%, 0.9%, 0.6%, and 0.3%. CONCLUSION: The prevalence of general diseases was not significant between Vietnam veterans and controls.

Clinical Study for the Photosensitive Disease / 대한피부과학회지

BACKGROUND: Although dermatologists may encounter photosensitivity patients commonly, most dermatologists are not familiar with diseases manifesting photosensitivity and there is still no clinical study on photosensitivity disease in Korea. OBJECTIVE: We tried to investigate incidences and sorts of photosensitivity diseases with clinical informations. METHODS: We performed a retrospective clinical review of patients who had photosensitivity as a chief complaint in the department of dermatology, Gyeongsang National University hospital from 1991 to 2000. RESULTS: There were a variety of diverse photosensitive diseases in this clinical study. Drug-induced photosensitivity including phototoxicity and photoallergy were fairly common (19.7%), and causative drugs were various including antibiotics, diuretics and even medicinal herb. We could find co-occurrence of some diseases in photosensitivity patients (39.3%), most of which were chronic degenerative diseases. CONCLUSION: Further clinical studies will be needed to get additional and standardized information in Korea, and precise clinical work-ups would be necessary to differentiate variable spectrums of photosensitivity diseases we showed in this study.

A Case of Photoallergic Contact Dermatitis Due to Ketoprofen Plaster / 대한피부과학회지

Ketoprofen, a propionic acid derivative is a non-steroidal anti-inflammatory drug with analgesic activity and it is used in the symptomatic treatment of rheumatoid arthritis and osteoarthritis. When exposed to sunlight, ketoprofen is broken down into various benzophenones. 3-ethyl-benzophenone as the major photoproduct is responsible for the photoallergic reaction to ketoprofen. A 30-year-old male presented with well-demarcated erythematous patches with itching sensation on both his ankle areas. He had applied Ketotop(R) plasters on both his ankle areas for arthralgia, and then the Ketotop(R) plaster-detached areas were exposed to sunlight. Patch test and photopatch test with?as is?showed positive reaction in photopatch test and the ingredients of Ketotop(R) plaster revealed positive reaction to the ketoprofen contained in Ketotop(R) plaster in photopatch test.

Contact Dermatitis due to Ketoprofen Patch(Ketotop(R)) / 대한피부과학회지

Ketoprofen is an nonsteroidal anti-inflammatory drug derived from propionic acid. It has been widely used as topical preparations, as gel or patch. It has been reported that topical ketoprofen can cause contact dermatitis and photocontact dermatitis. We experienced five cases of contact dermatitis, developed after applying ketoprofen patch(Ketotop(R), Pacific pharmaceutical Co., Korea) for the control of oste omuscular or joint pain. While one patient had generalized urticarial eruption, the rest of patents showed localized erythematous pruritic eczematous skin eruptions. It was verified through intradermal skin test and pin prick test that ketoprofen itself was not the causative drug for the skin eruption. Patch test excluded the possibility of allergic skin reaction to rubber compounds. It should be elucidated which compounds are allergic or toxic to the skin, contained in woven fabrics.