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A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen

We present the unique case of a 33-year-old male referred to our clinic in search of analgesic options who was found to have a delayed hypersensitivity reaction to ibuprofen manifesting as a maculopapular rash and acute urticaria to acetaminophen. Non-steroidal anti-inflammatory drugs are associated...

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Autores principales: Wong, Jason, Sandoval, Ashley, Jean, Tiffany, Naderi, Asal Gharib
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558799/
https://www.ncbi.nlm.nih.gov/pubmed/34733518
http://dx.doi.org/10.1177/2050313X211056409
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author Wong, Jason
Sandoval, Ashley
Jean, Tiffany
Naderi, Asal Gharib
author_facet Wong, Jason
Sandoval, Ashley
Jean, Tiffany
Naderi, Asal Gharib
author_sort Wong, Jason
collection PubMed
description We present the unique case of a 33-year-old male referred to our clinic in search of analgesic options who was found to have a delayed hypersensitivity reaction to ibuprofen manifesting as a maculopapular rash and acute urticaria to acetaminophen. Non-steroidal anti-inflammatory drugs are associated with predictable reactions as well as immunoglobulin E-mediated reactions or T-cell mediated reactions. This case highlights the importance of knowledge of the different types of reactions to non-steroidal anti-inflammatory agents as well as the risk of cross reactivity. Delayed reaction to a single non-steroidal agent is rare; urticaria to acetaminophen is very rare. This is the first report we have found in the literature where one individual has a delayed reaction manifesting as rash to ibuprofen as well as urticaria to acetaminophen. We challenged our patient to aspirin which helped identify that his delayed reaction was only to ibuprofen and urticaria only to acetaminophen. The case also highlights the importance of an oral provocation challenge when no contraindications exist which helped us find that he could take celecoxib and avoid narcotics as initial therapy.
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spelling pubmed-85587992021-11-02 A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen Wong, Jason Sandoval, Ashley Jean, Tiffany Naderi, Asal Gharib SAGE Open Med Case Rep Case Report We present the unique case of a 33-year-old male referred to our clinic in search of analgesic options who was found to have a delayed hypersensitivity reaction to ibuprofen manifesting as a maculopapular rash and acute urticaria to acetaminophen. Non-steroidal anti-inflammatory drugs are associated with predictable reactions as well as immunoglobulin E-mediated reactions or T-cell mediated reactions. This case highlights the importance of knowledge of the different types of reactions to non-steroidal anti-inflammatory agents as well as the risk of cross reactivity. Delayed reaction to a single non-steroidal agent is rare; urticaria to acetaminophen is very rare. This is the first report we have found in the literature where one individual has a delayed reaction manifesting as rash to ibuprofen as well as urticaria to acetaminophen. We challenged our patient to aspirin which helped identify that his delayed reaction was only to ibuprofen and urticaria only to acetaminophen. The case also highlights the importance of an oral provocation challenge when no contraindications exist which helped us find that he could take celecoxib and avoid narcotics as initial therapy. SAGE Publications 2021-10-28 /pmc/articles/PMC8558799/ /pubmed/34733518 http://dx.doi.org/10.1177/2050313X211056409 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Wong, Jason
Sandoval, Ashley
Jean, Tiffany
Naderi, Asal Gharib
A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen
title A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen
title_full A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen
title_fullStr A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen
title_full_unstemmed A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen
title_short A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen
title_sort case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558799/
https://www.ncbi.nlm.nih.gov/pubmed/34733518
http://dx.doi.org/10.1177/2050313X211056409
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