Allergic contact dermatitis from transdermal buprenorphine

Kim Vander Hulst, Elisabeth Parera Amer, Claude Jacobs, Virginie Dewulf, Marie Baeck, Ramón M. Pujol Vallverdú, Ana Giménez-Arnau, Dominique Tennstedt, An Goossens

Research output: Contribution to journalArticleResearchpeer-review

25 Citations (Scopus)

Abstract

Background: Buprenorphine is a low-molecular-weight, lipophilic, opioid analgesic. The transdermal delivery system (TDS) containing it has skin irritation potential, but at least two cases of contact allergy to the active principal have been described previously. Objective: To confirm allergic contact dermatitis from transdermal buprenorphine (TDB) in five older patients suffering from chronic pain and who developed persistent, pruritic erythematous plaques at the contact sites, with two of them also presenting with a generalized skin eruption. Methods: Besides the baseline patch test series, all five patients were tested with the TDB, four of whom were also tested with the placebo transdermal delivery system as provided by the manufacturer; one patient was also tested with other preparations containing buprenorphine. Results: All reacted to the TDB containing the active principal, the placebo being negative in the four patients tested. The patient tested with the other buprenorphine preparations did react positively to them as well. Tests with TDB in 28 healthy controls were negative. Conclusion: We report five cases of delayed hypersensitivity reactions to a TDS containing buprenorphine. Such adverse reactions might be under-reported. A fentanyl-containing TDS is a good alternative in these cases. © 2008 The Authors.
Original languageEnglish
Pages (from-to)366-369
JournalContact Dermatitis
Volume59
Issue number6
DOIs
Publication statusPublished - 1 Dec 2008

Keywords

  • Allergic contact dermatitis
  • Alternative
  • Analgesics
  • Buprenorphine
  • Fentanyl
  • Opioids
  • Pain control
  • Transdermal delivery system

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