Ibuprofen
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Ibuprofen Exudative erythema multiforme: case report A 32-year-old woman developed exudative erythema multiforme during treatment with ibuprofen. The woman had been receiving omeprazole and paracetamol [acetaminophen] for 1 week when she presented with pruritic maculopapular lesions on her face and dorsal hands. She reported similar lesions on her legs and arms 1 week after starting ibuprofen and paracetamol 1 year earlier. Skin prick tests to omeprazole, paracetamol and ibuprofen, as well as intradermal tests to omeprazole and paracetamol were negative. Patch tests to paracetamol and ibuprofen were also negative. Oral challenge tests with paracetamol 1000mg, omeprazole 40mg and ibuprofen 1000mg were negative. Therefore, treatment was continued with each drug for 1 week. No reaction was observed with paracetamol or omeprazole, but she experienced maculopapular lesions with pruritus and erythema on her elbows and dorsal hands after 7 days of treatment with oral ibuprofen 600mg every 12 hours. Histopathology of a skin biopsy was consistent with exudative erythema multiforme. The woman was prohibited from taking NSAIDs or arylpropionic acid. Diclofenac and etoricoxib were prescribed for 10 days, without a reaction [outcome not clearly stated]. Author comment: "We conclude that, in patients with a delayed reaction and depending on the clinical picture, it is important to continue treatment with the suspected drug to demonstrate tolerance and prevent misdiagnosis." Llamazares AA, et al. Ibuprofen-Induced exudative erythema multiforme after 1 week of continued therapy following oral challenge. Journal of Investigational Allergology and Clinical Immunology 22: 376-377, No. 5, Jan 2012 803079207 Spain
0114-9954/10/1427-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 10 Nov 2012 No. 1427
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