Overlap Between DRESS Syndrome and Exanthema Induced by Sulfadiazine in a Patient Treated With Sulfamethoxazole: Utility of the Lymphocyte Transformation Test for Identification of the Culprit Drug.

over a well-defined area on both arms. A subsequent singleblind, placebo-controlled oral challenge with aspirin revealed the same reaction (Figure), although a controlled challenge with celecoxib was negative. In the patient we report, the symptoms were elicited by various NSAIDs (ibuprofen, metamizole, and aspirin) and resembled the pattern of patients with a cross-reactive cutaneous phenotype of sensitivity to NSAIDs [6]. This observation suggests that the enzymatic inhibition of the cyclooxygenase type I isoform could play a role in the development of this specific reaction. The tolerance of highly selective cyclooxygenase type 2 inhibitors such as celecoxib in the present case reinforces this hypothesis. However, the nature of the relationship between COX-1 inhibition and the local immunological trace of mite remains largely unknown. To our knowledge, this is the first report of recall urticaria after scAIT that was elicited with various NSAIDs. This phenomenon might be a new cutaneous subphenotype of cutaneous NSAID hypersensitivity in patients with respiratory allergy treated with scAIT.