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DOI: 10.1055/s-0042-1746457
Systemic tolerance of diclofenac after allergic contact dermatitis to the topical formulation
Diclofenac (CAS 15307-86-5) is a widely used nonsteroidal anti-inflammatory drug (NSAID). In the topical formulation, its main application is in the therapy of actinic keratoses and minor sports injuries such as joint sprains or contusions. Allergic contact allergy after topical use of diclofenac and type IV reactions after oral administration are rarely reported. To date, there is no study on possible oral tolerance in patients with contact allergy to topical diclofenac. We report two patients with contact allergy to diclofenac and subsequent tolerance in oral provocation tests, which was tolerated up to 100 mg diclofenac orally despite proven and extensive previous contact allergy. We conclude that contact dermatitis cannot necessarily exclude the systemic application of the same compound. It has been hypothesized that "compartment allergies" may be responsible for such findings and in these cases recommend oral provocation, the gold standard in the clarification of hypersensitivity reactions.
Publication History
Article published online:
24 May 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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