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Occupational photocontact allergy produced by carprofen
Photobiology Unit, Ninewells Hospital, Dundee DD1 9SY, Scotland, UK
A 42-year old had an 18-month history of recurrent episodes of facial dermatitis that she attributed to working with Rimadyl® (a non-steroidal anti-inflammatory drug [NSAID], carprofen, used in veterinary medicine). By the time she attended the dermatology clinic this problem had caused her to resign from her work in a pharmaceutical factory. Patch testing and photopatch testing showed photoallergy to carprofen.
The same year, a 47-year old was admitted with erythrodermic dermatitis. Chronic actinic dermatitis was considered, amongst other possible diagnoses, but excluded by normal phototesting and patch testing. Later, it became evident that remissions of dermatitis, which tended to affect exposed sites more than covered sites, coincided with periods off work. She was a secretary in the same factory that the first patient had worked in. At first, her dermatitis remained undiagnosed; subsequent investigation included patch testing and photopatch testing to carprofen, which revealed both contact allergy and photoallergy. Although her exposure was indirect these results did appear relevant and her skin only completely cleared once she got a new job.
There are limited reports of patch testing and photopatch testing to this chemical so we tested controls. We stopped this after one of three controls developed active photoallergic sensitisation. After occupational health input to the factory, several members of staff there were referred of whom a further 3 were found to have carprofen photoallergy.
This NSAID appears to be a potent photoallergen with sensitisation possible after limited exposure. It remains in use in veterinary medicine and therefore photopatch testing should be considered in pet owners who present with an exposed site dermatitis.
Kerr AC, Muller F, Ferguson J, Dawe RS. Occupational carprofen photoallergic contact dermatitis. Br J Dermatol, 2008; 159: 1303-1308.
© Alastair Kerr (text) and Radoslaw Spiewak (source code).
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Document created: 30 August 2009, last updated: 31 August 2009.