Non-steroidal allergy trteatment anti inflam inflammatory drugs NSAIDs are medications used regularly in the treatment of arthritis and intermittently for feverpain and headache.
They are most commonly used systemically, allergy trteatment anti inflam, usually as an oral formulation but can also be used as a suppository or administered by intramuscular injection. Topical gels and creams containing NSAIDs may be applied to sports injuries, painful joints and, most recently, for the treatment of solar actinic keratoses sun spots. NSAIDs are taken by children and adults. Non-steroidal anti- inflammatory drugs can be classified by action effect on the COX enzymes and chemical structure as traditional, non-selective COX inhibitors or as selective COX2 inhibitors.
Many skin side effects are seen with many different medications and are not specific or diagnostic for any particular medication or chemical structure. Most are mild but they can rarely be life-threatening. NSAIDs are one of the commonest drug groups to cause skin side effects. The gastrointestinal tract and the skin are the two body systems most likely suffer a side effect with NSAIDs.
It is difficult to estimate the frequency of skin side effects with NSAIDs as they are commonly purchased without prescription, and only those reactions worrying enough to present to a hospital are usually recorded. In one prospective study of nearly 20, inpatients, 0. As with most drug-induced skin reactions, withdrawal of the trigger medication results in resolution of the allergy trteatment anti inflamalthough this may take some months and is not universal.
Topical diclofenac gel is available for the treatment nickel antibacterial sundamaged skin, including actinic keratoses. Skin side effects reported in clinical trials that were seen more commonly with the active gel compared to the vehicle placeboincluded allergic contact dermatitisallergy trteatment anti inflam, dryness irritant dermatitis and scaling. The use of topical NSAIDs gels or creams to treat pain has been reported to cause a photocontact dermatitis, allergy trteatment anti inflam.
Most commonly this has allergy trteatment anti inflam with ketoprofen gel with an incidence of 0. Often the reaction appears after stopping the application when the skin is next exposed to sunlight.
Therefore it is usually reported in summer. The reaction commonly extends beyond the area where the gel had been applied. The reaction can be severe, requiring hospital admission toothbrush antibacterial covers cap brush guard some cases. Testing has shown this to be a photoallergic contact dermatitiscrossreacting with other NSAIDs including tiaprofenic acid, fenofibrate, oxybenzone and benzophenone.
Bufexamac has also been reported to cause contact dermatitis, allergy trteatment anti inflam. NSAIDs can cause a pseudo- allergy due to their pharmacological effects with a prevalence rate of 0. It is believed to be due to inhibition of the enzyme COX1.
Typically in this condition, the reaction develops with multiple different drugs in this family, unlike a true allergy where it is a reaction to a specific drug.
The most common presentation of NSAID hypersensitivity is facial swelling, particularly around the eyes angioedema. In general, selective COX2 inhibitors are well tolerated by most patients who have experienced this reaction with non-selective NSAIDsbut skin reactions have been reported rarely even with these, allergy trteatment anti inflam. Total avoidance of aspirin and NSAIDs allergy trteatment anti inflam only essential where there has been a serious reaction such as upper airway swelling.
Pseudoporphyria resembles true cutaneous porphyria tarda. It was first reported with naproxen, but has subsequently been seen with other propionate type NSAIDs. It presents with skin blistering and fragility, sun sensitivity and scarring, so clinically looks like porphyria cutanea tarda, but on specific biochemical testing, there is no abnormality detected.
In children, early onset pauci-articular arthritis a type of arthritis affecting only one or two joints is a major risk factor for developing this skin reaction. Ceasing the naproxen did not always clear the skin problems. Patients suffering from chronic idiopathic or ordinary urticaria or dermographism may notice a worsening or relapse of their condition when taking aspirin or other NSAIDs.
The rash may appear within minutes to hours after taking any one of this group of medications. It is rarely serious but often involves the mucous membranes. True allergic reactions involving specific IgE can occur but are fortunately rare as they can be potentially fatal.
Salicylates including aspirin can cause mast cell degranulation and aggravation of symptoms in patients suffering from urticaria pigmentosa. There was some suggestion that taking allergy trteatment anti inflam NSAID longterm might prevent the development of nonmelanoma skin cancer.
However, the most recent analyses of skin cancer prevention trials suggest that longterm use of NSAID probably does not significantly prevent skin cancer development, but perhaps short term use may. Did you find this page useful? We want to continue to deliver accurate dermatological information to health professionals and their patients — for free.
Funding goes towards creating articles for DermNet, supporting researchers, and improving dermatological knowledge around the world. DermNet NZ does allergy trteatment anti inflam provide an online consultation service. If you have any types of antibacterial agents with your skin or its treatment, see a dermatologist for advice. Drug Safety ; Bolognia, J et al. European Journal of Dermatology. A global meta-analysis of randomized clinical trials.
Pharmacological Research ;