Diclofenac-Induced Allergic Contact Dermatitis: A Series of
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Case
A 62-year-old female patient diagnosed many years ago with rheumatoid arthritis, treated orally with methotrexate 10 mg/week, applied DSTG 1% gel twice daily on her left wrist under occlusive dressing. She noticed erythema with slight edema on the site of drug application on the third day of use (Fig. 1). She also complained of pruritus. The patient had no history of atopy, no allergy history in the past, no other recent drug intake apart from methotrexate. Discontinuation of DSTG 1% gel was strongly advised. Potent steroid cream (mometasone) was applied once daily for the following 2 weeks resulting in full recovery of the skin. Patient was referred to the Allergy Department for patch testing 3 weeks after the cessation of topical corticosteroid therapy. No sun exposure was allowed during the testing, any other treatments were forbidden. Patch test readings were done after 48 h and 72 h and were positive only to DSTG 1% (+/++) and 1% diclofenac sodium in petrolatum; therefore, the ACD to diclofenac sodium was confirmed. The Naranjo Adverse Drug Reaction (ADR) Probability Scale was used and the score was calculated (patient’s total score was 6, indicating a probable ADR).....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120621/
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