Pustular contact hypersensitivity to fluorouracil with rosacealike sequelae

A 51-year-old woman had a severe pustular contact hypersensitivity reaction to fluorouracil used to treat actinic keratoses on the face. The reaction was composed of long-lasting redness, facial flushing, exaggerated skin markings, and sensory changes. Physicians prescribing topical fluorouracil should be aware of its potential to produce such a severe reaction.