Delayed hypersensitivity to flurbiprofen

Immune-mediated reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are unusual, and true allergy to the drug flurbiprofen has never been documented. We observed a patient who developed a maculopapular rash 48 h after beginning oral therapy with this drug, and 2 days later, angioedema and hypotension. Patch tests with flurbiprofen were positive 48 and 72 h after application. The clinical and allergologic features of this case strongly suggest type IV hypersensitivity. Patch testing with NSAIDs is useful for confirming clinical diagnoses of delayed hypersensitivity to these drugs.