Widely used in the treatment of various eczemas.
Difficult to evaluate.
French contact dermatitis group (GERDA) recently reported 62 observations.
The first national pharmacovigilance inquiry (1993-95) in France reported 260 cases of local intolerance to topical NSAIDs among 11 million units sold.
Arylpropionic derivatives (ketoprofen).
Contact dermatitis, photocontact dermatitis, contact erythema multiforme.
The mean duration of application is 13 days ; eruption may be prolonged (mean duration 25 days) with frequent regional or generalized extension.
Oral administration of NSAIDs following cutaneous sensitization may lead to severe generalized eruption.
Patch-tests and photopatch-tests (UVA, UVB and total light).
Oral challenge may be dangerous and should be avoided.
Delayed contact hypersensitivity and virtual photocontact sensitivity (preponderance of UVA).
Cross-sensitivity exists between NSAIDs of the same family.
Photo allergy is due to the benzophenone moiety of ketoprofen, or thiophene-phenylketone moiety of tiaprofenic acid but not to the arylpropionic function.
Avoidance of causative family
Use of NSAIDs of other families if mandatory.
If there is photosensitivity to ketoprofen or tiaprofenic acid, avoid fenofibrate and benzophenones. Alminoprofen, fenoprofen, flurbiprofen, ibuprofen or naproxen may be tolerated in such cases.