DEXKETOPROFEN-INDUCED PHOTOCONTACT DERMATITIS 237 sults were positive for ketoprofen 1% other patients with contact derma- pet. (πππ), piketoprofen 2% pet. titis from ketoprofen (8) or Photocontact dermatitis A due to dexketoprofen (π) and Enangel 1.25% as is (ππ photocontact dermatitis from pike- π). toprofen (9). Patch and photopatch tests were Nancy Valenzuela, Lluis Puig, then done with the components of En- A Marı´a A. Barnadas and Agustin Alomar angel (dexketoprofen, trometamol, ethyl alcohol 96%, carbomer, laven- References Department of Dermatology, Hospital de la der essence HBE-8028), kindly pro- Santa Creu i Sant Pau, Sant Antoni M. Claret, vided by the manufacturer. Only the 1. Alomar A. Ketoprofen photodermat- 167, 08025 Barcelona, Spain itis. Contact Dermatitis 1985: 12: photopatch test with dexketoprofen 112–113. 1% pet. was positive at D4 (ππ). 2. Gracia Bara M T, Matheu V,Pe´rez A, Key words: arylpropionic derivatives; cross- Dı´az M P, Martı´nez M I, Zapatero L. Contact photodermatitis due to keto- sensitivity, dexketoprofen; enantiomer; profen and piketoprofen. Alergol In- ketoprofen; medicaments; non-steroidal munol Clin 1999: 14: 148–150. anti-inflammatory drugs; photoallergy; Discussion 3. Albe`s B, Marguery MC, Schwarze H photocontact dermatitis; piketoprofen. Photocontact dermatitis due to top- P, Journe´ F, Loche F, Bazex J. Pro- longed photosensitivity following ical ketoprofen was first reported in contact photoallergy to ketoprofen. 1985 in Spain (1), and has since been Dermatology 2000: 201: 171–174. the subject of several single case re- 4. Le Coz C, Bottlaender A, Scrivener ports and series, especially in coun- J, et al. Photocontact dermatitis from tries where topical application is ketoprofen and tiaprofenic acid: popular and/or sun exposure is likely cross-reactivity study in 12 consecu- Case Report (1–5). Cross-reactions have been tive patients. Contact Dermatitis A 61-year-old woman presented in demonstrated between ketoprofen 1998: 38: 245–252. November 2001 with an acute ec- and other arylpropionic derivatives, 5. Pigatto P, Bigardi A, Legori A, Valsecchi R, Picardo M. Cross-reac- zematous plaque, over the upper 1/3 such as tiaprofenic acid, suprofen, tions in patch testing and photopatch of her left leg, of 10days’ duration. ibuproxam, piketoprofen or flurbi- A testing with ketoprofen, thiaprophen- She had been applying Enangel profen, both clinically and by patch ic acid and cinnamic aldehyde. Am J (dexketoprofen trometamol 1.25%, and photopatch testing (2, 4, 5). Contact Dermat 1996: 7: 220–223. Laboratorios Menarini, Barcelona, Photoallergy is due to the benzo- 6. Bosca F, Miranda M A. Photosensit- Spain) 2¿to 3¿daily to that area for phenone moiety of ketoprofen, but izing drugs containing the benzo- several days prior to the onset. She ad- not to the arylpropionic function (4, phenone chromophore. J Photochem mitted to moderate sun exposure of 6). This induces cross-reactivity to Photobiol B 1998: 43: 1–26. the treated area, but did not recall any fenofibrate (3, 4), unsubstituted 7. Barbanoj M J, Antonijoan R M, Gich I. Clinical pharmacokinetics of previous topical or oral treatment benzophenone (4) and benzo- dexketoprofen. Clin Pharmacokinet with either ketoprofen or dexketop- phenone-containing sunscreens (3), 2001: 40: 245–262. rofen trometamol. The rash resolved such as benzophenone-3 or benzo- 8. Miralles J C, Negro J M, Sa´nchez- in 1week following topical cortico- phenone-10, which should probably Gasco´n F, Garcı´a M. Ketoprofen steroid treatment, without sequelae or not be used in such patients. contact dermatitis with good piketop- persistent photosensitivity. The therapeutic effect of keto- rofen tolerance. Alergol Inmunol Clin Patch test results with the GEIDC profen, a racemic mixture of 2 en- 2001: 16: 105–108. standard series were positive for antiomers, is due to the (S)-(π)-en- 9. Goday J J, Oleaga J M, Gonzalez M, nickel sulfate (πππ), Myroxylon antiomer (dexketoprofen), while the Del Pozo J, Fonseca E. Photoallergic contact dermatitis from piketoprofen. Pereirae resin (ππ), cobalt chloride (R)-(–)-enantiomer is devoid of bio- Contact Dermatitis 2000: 43: 315. (πππ), and palladium chloride (π logical activity (7). This is the 1st re- π). Patch test results with an NSAIDs port of topical photocontact derma- series (ketoprofen 1% pet., piroxicam titis from dexketoprofen trometamol, Address: 1% pet., diclofenac 5% pet., fepradin- to our knowledge. Our patient was Dr Agustin Alomar ol 1% pet., benzydamine chloride 3% also shown to cross-react to racemic Department of Dermatology pet., ibuprofen 5% pet., thiosalicylic ketoprofen and piketoprofen, which Hospital de la Santa Creu i Sant Pau Sant Antoni M. Claret, 167 acid 0.1% pet., phenylbutazone 1% are also available topically. Concomi- 08025 Barcelona pet., piketoprofen 2% pet.) plus Enan- tant sensitization to both ketoprofen A Spain gel 1.25% as (is) were negative. and piketoprofen has previously Tel. π34,932919013 Photopatch test (following ir- been described (2), but cross-reac- Fax: π34,932919136 radiation with UVA8J/cm2 at D2) re- tivity has not been demonstrated in E-mail: aalomar/hsp.santpau.es.