Immune-mediated reactions to NSAIDs are unusual. We have observed two
cases of maculopapular eruptions occurring 48-72 h after administratio
n of diclofenac sodium. Patch tests performed with diclofenac were pos
itive. The histopathologic findings resembled those of contact dermati
tis with different degrees of dermal involvement. Clinical, allergolog
ic, and histopathologic patterns strongly suggest a type IV mechanism
of hypersensitivity. Patch tests play an important role in the assessm
ent of possible immunologic mechanisms underlying cutaneous reactions
to drugs.