Photoaggravated contact allergy and contact photoallergy to ketoprofen: 19cases

Introduction. Between September 1994 and September 1999, we observed 19 cas es of photoaggraved contact allergy or contact photoallergy to ketoprofen ( non steroidal anti-inflammatory derived from arylpropionic acid). We presen t a clinical and photobiological retrospective study of these ig cases with investigation of cross. reactivity between berizophenone-containing molecu les. Patients and methods. On clinical level, we investigated the type of erupti on, the delay of appearance, the initial area of eruption and areas of diff usion. Phototesting included patchtests and photopatchtests performed with the gel containing ketoprofen (17 patients), ketoprofen 2 P.100 petrolatum (14 patients), fenofibrate lo P. loo petrolatum and lo p.100 water (15 pati ents), 3 benzophenones (19 patients): oxybenzone io p.100 petrolatum, mexen one 2 P, loo petrolatum, sulisobenzone io p. loo petrolatum and the other a rylpropionic derivatives (4 patients). Three identical series were applied: one was irradiated with 3/4 polychromatic minimal erythematosus dose, a se cond was irradiated with UVA 13 J/cm(2) until January 1997, then 5 J/cm(2), the third series was not irradiated (control series), Results. Patients were 9 men and 10 women with an average age Of 41,2 years . The type of eruption was an eczema. The delay of appearance of the erupti on was one day to 3 months, For 10 patients, the delay was between 4 and 18 days, The eruption was localized to the application area in 1 case, to the application area then to the same contralateral area in 3 cases, to the ap plication area then to all photoexposed areas in 13 cases, to the applicati on area then to the photoexposed areas and then to non-sun-exposed areas in 2 cases. Evolution showed prolonged photosensitivity in 3 cases after with drawal of the contact and the contact photoallergy to ketoprofen was severe . Gel-containing ketoprofen photopatchtests showed 9 photoaggravated contac t allergy, 6 contact photoallergy and 2 contact allergy, Ketoprofen photopa tchtests showed 12 contact photoallergy and 2 photoaggraved contact allergy , Tiaprofenic acid photopatchtests were positive in all performed cases (4/ 4), but photopatchtests with the other arylpropionic derivatives, without b enzophenone structure, were negative. Fenofibrate photopatchtests were alwa ys positive (15/15). Benzophenones photopatchtests only showed 4 cases of c ontact photoallergy to oxybenzone (4/19), in 68 p.100 of cases, patients pr esented a contact allergy or photoallergy to fragrances, Conclusions. This study shows the actual frequency of contact allergy and c ontact photoallergy to ketoprofen with a higher frequency of contact photoa llergy, Thus, photopatchtesting is essential, In cases of contact photoalle rgy to ketoprofen, ketoprofen, tiaprofenic acid but not the other arylpropi onic derivatives, fenofibrate and benzophenones have to be withdrawn.