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Bromfenac with Sodium Bisulfite Inducing Contact Dermatitis and Corneal Ring Infiltrate: A Case Report
Christopher D Gelston1, John J Fowler2, Brittany M Perzia1
1Ophthalmology, University of Colorado School of Medicine, Sue-Anschutz-Rodgers Eye Center, Aurora, CO, USA.
Introduction:
The aim of the study was to report a case of bromfenac with sodium bisulfite preservative induced contact dermatitis and a secondary sterile corneal ring infiltrate.
Case Presentation:
A 44-year-old male presented with a 1-week unilateral periocular dermatitis and eye redness. Initially the dermatitis responded to oral prednisone 80 mg and subsequent taper over 2 weeks. Upon tapering the prednisone, the patient returned with a recurrent dermatitis a week later. Dermatological workup included a skin biopsy demonstrating spongiotic dermatitis and a skin panel allergy test positive for sodium metabisulfite. The patient later mentioned self-administering bromfenac ophthalmic eye drops that contained sodium bisulfite. After the prolonged bromfenac use, the patient also developed a sterile corneal ring ulcer. The dermatitis finally resolved after discontinuing the bromfenac ophthalmic drops; however, the ring ulcer persisted after 3 months.
Conclusion:
Topical bromfenac ophthalmic drops may induce a severe contact dermatitis related to the inactive ingredient sodium bisulfite within the solution. Chronic use of the bromfenac may also cause a sterile ring infiltrate. Caution should be given to patients in using eye drops with sulfite sensitivity or allergy.
