Reactions 1463, p10 - 3 Aug 2013

Apronalide/caffeine/ibuprofen

Fixed drug eruption on the lips: case reportA 34-year-old woman developed fixed drug eruption on the

lips after receiving apronalide [allylisopropylacetylurea]/caffeine/ibuprofen.

The woman developed swollen lips after administration ofan analgesic containing apronalide, caffeine and ibuprofen fora headache [dosage, route, duration of treatment to reactiononset and outcome not stated]. Several months later, shereceived another analgesic containing apronalide, caffeine andibuprofen [dosage, route and indication not stated], andsubsequently developed blistering of her upper and lower lipsand right hand, as well as erythema on her left index finger.Pigmented lesions were also observed [duration of treatmentto reaction onset and outcome not stated]. As both analgesicscontained the active ingredients apronalide, ibuprofen andcaffeine, a fixed drug eruption caused by one of these drugswas suspected.

Closed patch tests for all three ingredients on nonlesionalskin were negative. The woman then underwent open patchtesting on the lesional skin of her lips. Erythema appearedwithin 5 minutes of the application of apronalide or ibuprofenat 20% w/w in petrolatum. No reaction occurred when caffeinewas applied.

Author comment: "The open patch test on the lesion wasconsidered a rapid, safe, and highly useful method for thediagnosis of fixed drug eruptions on transitional areasbetween the skin and mucosa."Inaba Y, et al. A case of fixed drug eruption on the lips caused byallylisopropylacetylurea and ibuprofen diagnosed by open patch tests. SkinResearch 12: 26-30, No. 1, Feb 2013 [Japanese; summarised from an Englishabstract] - Japan 803090869

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Reactions 3 Aug 2013 No. 14630114-9954/13/1463-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved