[Cutaneous side-effects of nonsteroidal anti-inflammatory drugs (NSAID)]

NSAID are able to induce cutaneous side-effects by both systematical and topical application. Nearly all kinds of exanthema are possible by any type of these drugs. However, particular substances are more likely to induce certain drug eruptions; aspirin and indometacine may induce urticarial reactions, whereas piroxicam can lead to phototoxic or photoallergic dermatitis. Contact dermatitis induced by topical NSAID is still rare but increasing. Ketoprofen and bufexamac were major contact allergens based on the number of reports, but local differences among different countries were observed. The diagnosis of drug reactions, especially in systemic drugs, remains a problem because reliable in vitro methods are not yet in use and skin test procedures do not work in most cases. Therefore, the case history is still the most useful tool in evaluating anamnestic allergic events. Prospective studies of drug compatibility as well as an improvement of side-effect reports are necessary to assess specific risks for several drugs.