Hypersensitivity to ketoconazole preparations: study of 4 cases

Diffey et a!. (8) were the first to describe photosensitivity to tiaprofenic acid; further reports confirmed its photosensitizing properties (9, 11). Recently, Neumann et a!. (7) photopatch tested 45 patients to tiaprofenic acid and, in 23 of them (51%), phototoxic reactions were found. Oral photoprovocation tests have demonstrated that tiaprofenic acid can also exhibit photosensitizing properties after systemic administration (12). In our patient, there was a history of topical use of tiaprofenic acid with ion to therapy and no history of systemic use of the drug; moreover, there was no history of topical and/or systemic use offlurbiprofen. It is interesting that the patient had a relapse of lesions after oral intake of ketoprofen tablets, but that patch and photopatch testing with ketoprofen 2, 5 and 10% pet. gave negative results. In the light of these results, we consider that: (i) true cross-reactivity probably does not exist between tiaprofenic acid and ketoprofen, but that there is probably a group pharmacological reactivity; (ii) in photodiagnostic procedures, we must evaluate the role that different energies may have on the reactions of these compounds; (iii) our patient is a true case of allergic photocontact dermatitis from tiaprofenic acid, with propionic acid group reactivity.